Author

Cardoso T. MD, Mendez C. M. MD, Jimenez I. Centro Internacional de Restauracion Neurologica.

Introduction

The spinal cord injuries (SCI) and their consequences are the most important causes of disabilities and have a negative impact in the quality life. In 1944, with the creation of a multidisciplinary treatment center for SCI at Stoke-Mandeville by Sir Ludwig Guttman, a new vision started in the treatment and rehabilitation of SCI patients. In the last years, the comprehension related to physiopathology and the complications of that kind of lesions, the pharmacological, surgical and rehabilitation treatments, has been increased. In other side, the plastical abilities of nervous system and the better understanding of the repairing process, give a better perspective in the evolution of the patient.

Case history

A 28-years-old woman patient with a spinal cord injury at T-5 after a motor vehicle accident 3 years ago, with physical therapy 1 month after the accident, came to our hospital to receive the neurorestorative treatment program. She was sent to the Department of Traditional Chinese Medicine as part of the Center teamwork intensive treatment. In the evaluation, she complained of a loss of motility in their legs, inability to walk, loss of sensibility. She suffers also a neurogenic intestine and bladder but there was not urinary infection when the consultation. At physical exam, it was found that tone was increased (4 in Ashworth scale on right leg and 3 on left) and trophism decreased bilateral, the muscle strength was absent under the lesion level. The sensibility abolish under T-9 on back side and 4 cm under the ribs edge in abdomen, for all the modalities of the sensibility . According to the bioenergetic diagnostic, it was considered as a syndrome wei traumatic, with emptiness and stagnation of Qi and blood in the channels and collaterals.

Treatment

She received intensive physical rehabilitation and acupuncture in the neurorestorative treatment program. The general strategy was to regulate the Qi in the Du Mai (Governor vessel) and Dai Mai (Girdling vessel), nourish the Kidney and Spleen, tonify qi and blood in the channels and collaterals to promote free circulation of qi and blood. Acupuncture was applied in the point Houxi SI-3 to open the Du Mai or Zulinqi GB-41 to open Dai Mai, then at Huatojiaji points at the level of lesion, superior and inferior to that level too. Yangming channel points such as Futu ST-32, Zusanli ST-36, Jiexi ST-41 and to the points Yanglingquan GB-34, and Xuanzhong GB-39, were applied. She was treated three times a week for 1 month .

Result

The second day of starting treatment, she feels a sensation like electricity during stimulation of the needles (in Zulinqi GB-41, Zusanli ST-36, Jiexi ST-41) and an irradiation to the leg. In the 5th session she said she has started to feel at hypogastric level, and at physical exam the level of sensation has descended to L1. There were no changes in the muscle strength. In the 10th session, she said she moves intestines better and the level sensation follows descending, at physical exam the level of sensation has descended to L4 and there were contractions of muscles without movement more evident in quadriceps in both legs. The temperature of the legs and especially the knees, increase on palpation.

Comments

It was interesting to observe the presence of important sensitive changes in a patient with a paraplegia post trauma several years after the accident and to verify muscle strength changes during the treatment. The sensitive and motor improvements could be related with neuroplastic changes stimulated by Acupuncture and intensive physical rehabilitation.


Other comments to the author: tahimi


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