Can scoliosis lead to spinal cord ischaemia? Early diagnosis and rehabilitation: A paradigmatic case report and literature review

Author:

Lippi Lorenzo1,de Sire Alessandro12,Desilvestri Manuela3,Baricich Alessio14,Barbanera Andrea5,Cattalani Andrea5,Invernizzi Marco1,Perrero Luca3

Affiliation:

1. Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy

2. Rehabilitation Unit, “Mons. L. Novarese” Hospital, Moncrivello, Vercelli, Italy

3. Rehabilitation Unit, Rehabilitation Department, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy

4. Physical and Rehabilitation Medicine Unit, University Hospital “Maggiore della Carità”, Novara, Italy

5. Neurosurgical Unit, Surgical Department, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy

Abstract

INTRODUCTION: Scoliosis is frequently associated with pain and radiculopathy, but it is not considered a possible cause of acute spinal cord injury (SCI). Here we present a case report in which scoliosis was apparently linked to spinal cord ischaemia. CASE PRESENTATION: A 20-year-old woman with conservatively treated severe scoliosis presented with acute spinal cord infarction, which occurred during a spinal flexion while she was tidying up the bed. Other causes of SCI were excluded. Early rehabilitation was started and the patient progressively regained motor and sensory functions, with an AIS reduction from A to C. Bowel and bladder disorders persisted and were autonomously managed with a trans-anal irrigation device and intermittent catheterisation after voluntary micturition. DISCUSSION: Early detection and management of spinal curvature disorders are essential in preventing long-term complications of scoliosis. Although the aetiology of spinal cord ischaemia in severe scoliosis should be better clarified, this rare case report suggests that scoliosis might be involved in its pathogenesis. Thus, we recommend early diagnosis of spinal curvature disorders and adequate rehabilitative treatment in order to prevent potential subsequent neurological complications.

Publisher

IOS Press

Subject

Rehabilitation,Physical Therapy, Sports Therapy and Rehabilitation,Orthopedics and Sports Medicine

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