Spinal cord injury (SCI) is life-disrupting condition. Historically, it has been associated with very high mortality rates. Paraplegia is impairment of the motor or sensory functions of the lower extremities often including the lower part of the trunk. It is usually caused by SCI. The area of spinal canal that is affected in paraplegia is the thoracic, lumbar, or sacral regions. Here, an attempt is made to explain the case of a 26-year-old female with burst fracture L1 (AO type A) with American Spinal Injury Association (ASIA) paraplegia with bowel bladder involvement due to a fall from height. Pedicle screw fixation was performed at three vertebral bodies (D12, L1, and L2). Even after surgery, complete motor and sensory deficit was present in bilateral lower limb, bowel, and bladder. According to the Ayurvedic view, patient was diagnosed as a case of “Adharanghata” and was planned for Panchakarma procedures as Udwartana (powder massage), Virechana, and Yapana Basti for 2 months.
Outcomes: Patient\'s spinal cord independent measure (SCIM) score improved to 88/100, which was 51/100 at the beginning of Panchakarma. Patient developed motor and sensory activities of the lower limb without difficulty and also became independent in basic activities of daily living like bathing, toileting, climbing, etc. She became independent in instrumental activities of daily living like going to the market, hospital, and temple. After the above course of procedures, the patient showed marked improvements in sensory and motor modalities. The patient on wheelchair could now walk without support.
Guttmann, L. Spinal cord injuries: comprehensive management and research. London: Blackwell Scientific Publications; 1973. p. 1.
Gerhart KA, Koziol-McLain J, Lowenstein SR, Whiteneck GG. Quality of life following spinal cord injury: knowledge and attitudes of emergency care providers. Ann Emerg Med 1994 Apr;23(4):807-812.
Maynard FM, Muth AS. The choice to end life as a ventilatordependent quadriplegic. Arch Phys Med Rehabil 1987 Dec;68(12):862-864.
Kewman DG, Tate DG. Suicide in SCI: a psychological autopsy. Rehabil Psychol 1998;43(2):143-151.
Gosselin RA, Coppotelli C. A follow up study of patients with spinal cord injury in Sierra Leone. Int Orthop 2005 Oct;29(5):330-332.
Allotey P, Reidpath D, Kouamé A, Cummins R. The DALY, context and the determinants of the severity of disease: an exploratory comparison of paraplegics in Australia and Cameroon. Soc Sci Med 2003 Sep;57(5):949-958.
WHO/World Bank. World report on disability. Geneva: World Health Organization; 2011.
American Spinal Injury Association. International standards for neurological classifications of spinal cord injury. Revised ed. Chicago (IL): American Spinal Injury Association; 2000. pp. 1-23.
Paternostro-Sluga T, Grim-Stieger M, Posch M, Schuhfried O, Vacariu G, Mittermaier C, Bittner C, Fialka-Moser V. Reliability and validity of the Medical Research Council (MRC) scale and a modified scale for testing muscle strength in patients with radial palsy. J Rehabil Med 2008 Aug;40(8): 665-671.
Wernig A, Nanassy A, Muller S. Laufband (treadmill) therapy in incomplete paraplegia and tetraplegia. J Neurotrauma 1999 Aug;16(8):719-726.
Wernig A, Nanassy A, Muller S. Maintenance of locomotor abilities following Laufband (treadmill) therapy in para- and tetraplegic persons: follow-up studies. Spinal Cord 1998 Nov;36(11):744-749.
McDonald JW, Becker D, Sadowsky CL, Jane JA Sr, Conturo TE, Schultz LM. Late recovery following spinal cord injury. Case report and review of the literature. J Neurosurg 2002 Sep;97(Suppl 2):252-265.
Kirshblum S, Millis S, McKinley W, Tulsky D. Late neurologic recovery after traumatic spinal cord injury. Arch Phys Med Rehabil 2004 Nov;85(11):1811-1817.
Lim PA, Tow AM. Recovery and regeneration after spinal cord injury: a review and summary of recent literature. Ann Acad Med Singapore 2007 Jan;36(1):49-57.
Scivoletto G, Morganti B, Ditunno P, Ditunno JF, Molinari M. Effects of age on spinal cord lesion patients’ rehabilitation. Spinal Cord 2003 Aug;41(8):457-464.
Evaniew N, Belley-Côté EP, Fallah N, Noonan VK, Rivers CS, Dvorak MF. Methylprednisolone for the treatment of patients with acute spinal cord injuries: a systematic review and meta-analysis. J Neurotrauma 2016 Mar;33(5):468-481.