Perioperative rehabilitation management for a child with spinal muscular atrophy: one case report

doi:10.3969/j.issn.1672-6731.2023.09.011

Abstract

Key words: Spinal muscular atrophies of childhood, Spinal curvatures, Exercise therapy, Case reports

Wen-zhu LI, Chen-hao WANG, Zhen HUANG, Cui-jie WEI, Hui XIONG, Bei-yu XU, Chun-de LI, Cheng-li QUE. Perioperative rehabilitation management for a child with spinal muscular atrophy: one case report[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2023, 23(9): 838-843.

李文竹, 王晨昊, 黄真, 魏翠洁, 熊晖, 徐贝宇, 李淳德, 阙呈立. 儿童脊髓性肌萎缩症围手术期康复治疗一例[J]. 中国现代神经疾病杂志, 2023, 23(9): 838-843.

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https://journal11.magtechjournal.com/cjcnn/EN/Y2023/V23/I9/838

Figures/Tables 4

Figure 1 Comparison of full - length spinal imaging findings and lateral curvature before and after surgery Preoperative full - length spine X - ray (Panel 1a) and CT (Panel 1b) showed obvious lateral curvature of the neck, chest and lumbar vertebrae in an "S" shape with a Cobb of 63°. The right shoulder was higher than the left side, the left back was raised, and the pelvis was tilted before the surgery (Panel 1c). Preoperative full - length spine X - ray (Panel 1d) and 3D - reconstruction CT (Panel 1e) showed significant improvement in cervical, thoracic and lumbar scoliosis with a Cobb of 18°. Both bilateral back symmetry and pelvic tilt were improved after surgery (Panel 1f).

Table 1. Clinical assessments of body structure and function before and after surgery

评估时间	身高（cm）	体重（kg）	BMI（kg/m²）	%MRC	背伸角度（°）		伸展角度（°）		Cobb角（°）
评估时间	身高（cm）	体重（kg）	BMI（kg/m²）	%MRC	右踝	左踝	右髋	左髋	Cobb角（°）
术前1天	140	35.30	18.01	55.00	4	8	20	16	63
第3次注射后	149	38.00	17.10	62.50	4	8	25	25	18

Table 2. Isometric muscle strength in the main muscle groups of the right limb before and after surgery (kg)

评估时间	肩外展	肘屈曲	髋屈曲	髋伸展	髋外展	膝屈曲
术前1天	3.30	5.70	1.10	1.20	1.70	2.60
第1次注射后	4.80	7.10	2.20	2.40	3.30	2.40
第2次注射后	4.70	7.40	3.40	3.70	4.50	2.60
第3次注射后	5.30	8.60	3.60	4.30	4.00	3.00

Table 3. Clinical assessments of activities before and after surgery (score)

评估时间	HFMSE	RULM	MFM
评估时间	HFMSE	RULM	总评分	D1	D2	D3
术前1天	33	34	57	3	33	21
第1次注射后	31	36	58	3	34	21
第2次注射后	31	36	58	3	34	21
第3次注射后	31	36	59	4	34	21

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