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Rehabilitation Practice and Science

Translated Title

僵直性脊椎炎併雙位脊髓損傷患者之自主神經異常反射：病例報告

Abstract

This 54-year-old man underlying ankylosing spondylitis suffered from double spinal cord injuries with traumatic C6/7 dislocation and a neglected L1 vertebral body fracture which progressed to transverse fracture three weeks after the injury, acting as a powerful precipitant to autonomic dysreflexia. The dysreflexic symptoms happened at least three times when he practiced sitting during mat exercise and ameliorated soon by virtue of lying down. Compared with the previous record checked three weeks ago, neurologic examination revealed alteration of sensory level and loss of deep anal sensation. The patient received L1 laminectomy as well as T12 and L2 transpedicle screws fixation, but L1 vertebral body was collapsed one month after the operation. In the second operation, T11-L3 pedicle screws fixation with cross links and L1 intrabody bone autografts were performed. After that, the dysreflexic symptoms were relieved. To our knowledge, there are not many casereports describing that the instability of spine may trigger autonomic dysreflexia. Therefore, as posture induced autonomic dysreflexia or new neurological deficits occur in high level SCI, the differential diagnosis may include a second spine lesion that causes unstable spine.

Language

English

First Page

171

Last Page

177

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