Neuromuscular Rehabilitation: Rehabilitation Improves Functional Independence and Respiratory Outcome after Multiple Laminectomy in Spinal TB: A Case Report
Main Article Content
Keywords
Spinal TB, Laminectomy, Spinal Orthosis, Rehabilitation
Abstract
Background: Pott’s disease is the most common skeletal tuberculosis. Rehabilitation should be considered to improve functional outcome in Pott’s disease.
Case: A 30-year-old woman with tuberculosis of vertebra-thoracal-11 (VTh11) to vertebra-lumbal-1 (VL1) presented with bilateral legs weakness, numbness, paresthesia, and back lump. The muscle strength was decreased at the level of L2 to Sacrum-1 (S1), with bilateral sensory deficit at the level of L2. Voluntary anal contraction and deep anal pressure were positive. Thoraco-lumbal X-Ray revealed second grade collapse of corpus VTh12 and third grade wedge compression fracture at VL1 with gibbus deformity and kyphotic angle of 68°. Posterior screw fixation and multiple laminectomy then was performed, followed by rehabilitation and thoraco-lumbo-sacral-orthotic (TLSO). On discharge, functional independence measure (FIM) increased from 43 to 118, while respiratory count test enhanced from 15 to 24.
Conclusion: along with medication and surgery, rehabilitation is important to improve functional outcome in pott’s disease.
References
2. Rajasekaran S, Soundararajan D. C. R, Shetty A. P., Kanna R. M. (2018). Spinal Tuberculosis: Current Concepts. Glob Spine J. 8(4_suppl):96S-108S. https://doi.org/10.1177/2192568218769053
3. Reihani, H., Zarei, F., Soltani, A., & Saeedi-Moghadam, M. (2022). A notable improvement in spontaneous intracranial hypotension (SIH) after delivery in a pregnant woman: A case report. Radiology Case Reports, 17(10), 3763-3766. https://doi.org/10.1016/j.radcr.2022.01.070
4. Tidja, Y. E. A., Mustokoweni, S., & Saleh, T. A. (2020). Bone tuberculosis: clinical profile of 40 patients in Dr. Soetomo General Hospital Surabaya. Jurnal Ilmiah Mahasiswa Kedokteran
Universitas Airlangga, 11(01). https://doi.org/10.20473/juxta.v11i12020.1-5
5. Oktamianti, P., Bachtiar, A., Sutoto, S., Trihandini, I., Prasetyo, S., Achadi, A., & Efendi, F. (2021). Tuberculosis control within Indonesia's hospital accreditation. Journal of Public Health Research, 10(3), jphr-2021. https://doi.org/10.4081/jphr.2021.1979
6. Viswanathan V. K, & Subramanian S. (2022). Pott Disease.
7. Mak, K. C., & Cheung, K. M. (2013). Surgical treatment of acute TB spondylitis: indications and outcomes. European Spine Journal, 22, 603-611. https://doi.org/10.1007/s00586-012-2455-0
8. Anil, K. J. (2002). Treatment of tuberculosis of the spine with neurologic complications. Clinical orthopaedics and related research, 398, 75-84. https://doi.org/10.1097/00003086-200205000-00011
9. Connolly, P. J., & Grob, D. (1998). Controversy: Bracing of patients after fusion for degenerative problems of the lumbar spine-Yes or no?. Spine, 23(12), 1426-1428. https://doi.org/10.1097/00007632-199806150-00024
10. Chui, K. C., Jorge, M., Yen, S. C., & Lusardi, M. M. (2019). Orthotics and Prosthetics in Rehabilitation E-Book. Elsevier Health Sciences. United States: Elsevier Health Scinece; 2019. 832 p.
11. Nas, K., Kemaloğlu, M. S., Çevik, R., Ceviz, A., Necmioğlu, S., Bükte, Y., ... & Kirbaş, G. (2004). The results of rehabilitation on motor and functional improvement of the spinal tuberculosis. Joint Bone Spine, 71(4), 312-316. https://doi.org/10.1016/S1297-319X(03)00135-0
12. Yong, L. N., Ahmedy, F., Yin, K. N., & Engkasan, J. P. (2021). Functional outcomes in spinal tuberculosis: a review of the literature. Asian spine journal, 15(3), 381. https://doi.org/10.31616/ASJ.2020.0086
13. Lee, C. S., Kang, K. C., Chung, S. S., Park, W. H., Shin, W. J., & Seo, Y. G. (2017). How does back muscle strength change after posterior lumbar interbody fusion?. Journal of Neurosurgery: Spine, 26(2), 163-170. https://doi.org/10.3171/2016.7.SPINE151132
14. Zaoui, A., Kanoun, S., Boughamoura, H., Maitigue, M. B., Bouaziz, M. A., Khachnaoui, F., & Rejeb, N. (2012). Patients with complicated Pott's disease: Management in a rehabilitation department and functional prognosis. Annals of physical and rehabilitation medicine, 55(3), 190-200. http://dx.doi.org/10.1016/j.rehab.2012.02.004.