Partial Recovery of Traumatic Spinal Cord Injury Following Posterior Decompression/ Free Hand Pedicle Screw Instrumentation: A Case Report

Abstract

Spinal cord injuries can be highly disabling. Although effective treatment for spinal cord injuries remains limited, operative stabilization and decompression of the neural canal may give rise to a better outcome and a faster rehabilitation. We report the operational management and rehabilitation of a 30-year-old woman who sustained L1 traumatic spinal cord injury with paraplegia (ASIA B) after being hit on the back by a pack of falling bricks. She sustained multiple vertebral fractures and a traumatic spondylolisthesis of L2/ L3, with canal stenosis were noted at the same level on MRI. Pedicle screw fixation of L1 to L4 (free-hand technique) was done with decompression of L2/L3 segments. Immediate recovery of power to the hip flexors was noted on the second post-operative day, with corresponding reduction in low back pain and  subsequent mobilization on wheel chair at the end of the second post-operative week. At the end of the eight post-operative week, patient began full weight bearing on a Zimmer’s frame without support.

Key words: Spondylolisthesis, Neural canal, ASIA, Spinal recovery