Amad Mohd Khany-Spinal cord injury (Saudi Arabia) Posted on October 20, 2014
Name: Amad Mohd Khany 
Sex: Male
Country: Saudi Arabia
Age:28 years
Diagnosis: Spinal cord injury
Date: September 21, 2014
Days Admitted to Hospital: 21 days
Before treatment:
The patient suffered from car accident and damaged thoracic vertebra in February 2014. He suffered from movement disorders, sensory disorders, and bowel and bladder dysfunction. He received MRI examination and showed the T12 vertebral fracture. He received thoracic vertebra fracture fixation in local hospital and kept catheterization. After operation, the patient started with rehabilitation. The movement disorders, sensory disorders, bowel and bladder dysfunction had no improvement. Before treatment, his lower limbs still had no autonomic activities. He could sit up with support of arms.
From the onset of disease, the patient had normal spirit. The diet was normal. He suffered gatism. The weight had no obvious change.
Admission PE:
Bp: 112/69mmHg; Hr: 74/min. Temperature: 36.3 deg. Br: 19/min. The nutrition was normal. The development was normal. He was thin. There was surgery scars in back and the length of scar was 17-18cm. There was surgery scars in chest and the length of scar was 5-6cm. The thorax was symmetrical. The respiratory sounds in both lungs were clear, with no obvious moist rales. The heart sounds was strong, the rhythm of his heartbeat was normal. There was no obvious murmur in the valves. The abdomen was sunken and soft, with no obvious masses. The liver and spleen under the ribs were not enlarged. There was no edema in both lower limbs.
Nervous System Examination:
Amad Mohd Khany was alert and his speech was fluent. His memory, calculation and orientation abilities were normal. Both pupils were equal in size and round, the diameter was 3.0mms, both eyeballs could move freely. Both eyes had sensitive response to light stimuli. The forehead wrinkle pattern was symmetrical. The tongue was centered in the oral cavity and the teeth were shown without deflection. The neck moved normally. The muscle strength of both upper limb was at level 5. The muscle strength of waist and back were at level 4+. There was muscle atrophy in both lower limbs. The muscle strength of both lower limbs was at level 0. The muscle tone of both lower limbs was slightly low. The tendon reflex of both upper limbs could be elicited. The abdominal reflex was not elicited. The patellar tendon reflex of both lower limbs disappeared. The pathological reflex of four limbs was negative. The deep sensation, shallow sensation and sophisticated sensation below T10 was slow down. The deep sensation, shallow sensation and sophisticated sensation below T12 disappeared. He was able to perform the finger-to-nose test and the rapid rotation test in a normal manner. He was unable to finish the heel-knee-tibia test.
Treatment:
We initially gave Amad Mohd Khany a complete examination and he was diagnosed with SCI. The patient received treatment for nerve regeneration and to activate stem cells in vivo. He received treatment to improve the blood circulation in order to increase the blood supply to the damaged neurons and to nourish them. We also gave him daily physical rehabilitation. According to the change of his condition and the test results, we adjusted the treatment.
Post-treatment:
The sensory system and motor function has improved. The deep sensation, shallow sensation and sophisticated sensation between T10 and T11 are near-normal level. Especially the left side has obvious improvement. The deep sensation, shallow sensation and sophisticated sensation between T11 and T12 has some improvement. The abdominal reflex can be elicited. The muscle strength of both lower limbs has reached level 1+. The nutritional status has some improvement.