Research Article


Rehabilitation of a patient with spinal cord lesion due to surgical removal of the spinal tumor with chronic idiopathic demyelinating polyneuropathy (CIDP): A case report

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1 Centre for the Rehabilitation of the Paralyzed (CRP), Savar, Dhaka, Bangladesh

2 Clinical Physiotherapist, Centre for the Rehabilitation of the Paralyzed, Dhaka, Bangladesh

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Md Zakir Hossain

Centre for the Rehabilitation of the Paralyzed (CRP), Savar, Dhaka,

Bangladesh

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Article ID: 100056D05MH2023

doi: 10.5348/100056D05MH2023RA

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How to cite this article

Hossain MZ, Sohana A, Islam MW, Afridi S. Rehabilitation of a patient with spinal cord lesion due to surgical removal of the spinal tumor with chronic idiopathic demyelinating polyneuropathy (CIDP): A case report. Edorium J Disabil Rehabil 2023;9(2):15–22.

ABSTRACT


Aims: The literature provides numerous medical therapies for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and spinal cord lesion following spinal tumor surgery separately. Spinal cord injuries from CIDP-related spinal tumors have no evidence-based rehabilitation methods. This case report discusses CIDP, spinal cord lesion owing to a spine tumor, and tertiary care interdisciplinary rehabilitation. It shows how medical knowledge, clinical reasoning, and evidence guide outcome measures, care plans, and clinical decisions help to overcome CIDP.

Methods: In this report, we follow a 27-year-old male who began experiencing gradual paresthesia and mild weakening in his lower extremities for six weeks. After two months, the lumbar spine had the initial operation (laminectomy) because of the extreme pain. After the operation, he was pain-free, able to walk, and even started riding again. Pain in his lower midback, similar to cramping, and moderate swelling in his left ankle forced him into a wheelchair three years after his initial operation (intradural-extramedullary spinal space-occupying lesion at L2–L5 level). After the second operation (laminectomy), he had trouble in walking, lost sensation below the knees on both legs, and experienced mild incontinence. As the patient was confined to a wheelchair, he was standing with the help of two people. Significant main muscle group weakening was one of the first noticeable symptoms. Therapeutic exercise, balance training, functional training, and progressive endurance activities were the main components of the intervention. Berg balance score increased from 5 to 23, which is an eligible score for discharge.

Results: Clinical outcomes for the man with spinal cord lesion and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) were improved with interdisciplinary therapy. The patient underwent a first lumbar spine operation, which initially eased pain and allowed him to walk and ride again after feeling gradual paresthesia and minor weakened in his lower extremities.

Conclusion: For this patient with CIDP with spinal cord lesion due to spinal tumor, effective collaborative team communication and interdisciplinary management worked to optimize clinical decision making and recovery.

Keywords: Chronic inflammatory demyelinating polyneuropathy, Demyelinating conditions, Rehabilitation, Spinal tumor

SUPPORTING INFORMATION


Acknowledgments

The authors thank Md. KM Arman Hossain, Jashore Universiy of Science & Technology for his valuable suggestion and guidelines and also extend their heartful thanks to Md. Akhlasur Rahman, Junior consultant, Spinal Cord Injury Unit, CRP for his technical support.

Author Contributions

Md Zakir Hossain - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Akter Sohana - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

MD Waliul Islam - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Drafting the article, Final approval of the version to be published

Shahid Afridi - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Guaranter of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2023 Md Zakir Hossain et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.