Spinal Orthotic Case Study

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Introduction The road to recovery for a patient with spinal cord injury (SCI) is a difficult one. Depending on the location and severity of the SCI, an individual’s life may be drastically altered. In some cases, full recovery is not possible and a degree of neurological function is lost. It is the goal of the orthotist(s) to provide the patient with orthotic intervention that will promote healing, reduce injury, and/or increase the individual’s quality of life. Case Presentation A 27-year-old male involved in a motor vehicle accident has sustained an unstable C7 anterior burst fracture and a C7 incomplete spinal cord injury resulting in C7 ASIA B tetraplegia. Individuals categorized as ASIA B preserve sensory function but lose motor function below the neurological level injured and includes sacral segments S4 and S5. Spinal compression fractures propagate along the anterior column of the spine, and tend to be stable injuries. When the fracture propagates in more than one column, it is called a burst fracture. According to Duke Orthopaedics, burst fractures are the result of compressive failure of the anterior and posterior vertebral body and failure of the anterior and middle columns. The intravertebral disc experiences increased nuclear pressure and hoop, or circumferential, stresses are applied to the annulus as a result of axial load. High shear stresses are applied to the vertebral end plate at the interior border of the annulus. Cervical burst fractures are most common at the level of C5-C6 and lower cervical burst fractures are frequently unstable. An unstable burst fracture is most notably accompanied by a neurological deficit1. The patient has undergone operative decompression and fusion with instrumentation. A post op evaluation revealed that the patient is capable of scapular elevation and depression, shoulder flexion and

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