Available online 14 December 2022

Author links open overlay panelAbstractBackground

Spinal cord injury (SCI) is a major problem worldwide, which can result in partial or complete loss of sensory function and motor control. Injured people are 2-5 times more likely to suffer premature death than their uninjured counterparts.

Case Information

This case reports the injuries sustained by a 41-year-old woman who jumped from a building being bombed in Kyiv, Ukraine, and her subsequent treatment and recovery.

The patient suffered a complete spinal cord injury (SCI), lower distal paraplegia, and dysfunction of pelvic organs, with orthopedist reporting she would likely never walk again. She substantially recuperated after the integration of acupuncture and physical therapy (PT) in her rehabilitation. Utilizing electrical, manual, and scalp acupuncture along with PT, the patient regained full bowel control, improved bladder function, and gained ability to support orthostatic position.

Conclusions

Acupuncture is cost effective and easy to perform in hospital settings. It has an important role to play in the rehabilitation of injuries. The integration of acupuncture and PT may significantly improve motor and neurological functions for SCI patients.

Introduction

SCI rehabilitation is a major worldwide challenge, with high costs, health complications, and mortality secondary to complications.1 There are no therapies to regenerate the spinal cord after injury, although early intervention to reduce inflammation can reduce complications.2 Existing therapies focus on prevention and treatment of complications, and physical therapy to maximize daily functioning.3 Activity-based therapies drive some neuromuscular activation below the injury.4

Acupuncture clinical research shows effectiveness in treating SCI sequelae.5,6  Scalp acupuncture is clinically effective in treating paralysis.5 One animal study showed electro-acupuncture is effective in neural function regeneration by suppressing Notch signaling pathways, allowing for neural stem cell proliferation, and inhibiting differentiation into astrocytes.7

In this case, a patient with SCI was effectively treated with scalp, manual, and electrical acupuncture and PT, leading to significant improvement in neurological and functional deficits. This case focuses on the acupuncture therapy administered.

Section snippetsNarrative

The patient is a 41-year-old female, who jumped from the second floor during bombing of Kyiv, Ukraine. She was diagnosed with a T11 fracture, and T12 fracture-dislocation with spinal cord damage at that level, leading to paralysis of the lower limbs and dysfunction of pelvic organs. (Figure 1: MRI) She was evacuated to Poland and admitted to a hospital for PT. The orthopedist wrote there would be no observable recuperation of patient's functions due to the nature and extent of the damages.

Patient Perspective

The patient affirms the remarkable progress she made and consented to this case report. (Personal communication, October 2022)

Discussion

Complete traumatic SCI of the thoracic vertebrae is a devastating injury that often leads to permanent disability.10 This is because the CNS neurons cannot regenerate.11 However, research done on rats has shown that electro-acupuncture can inhibit the mechanisms preventing regeneration.7 This may be the mechanism underlying the marked improvement in the patient's ability to move and function. To our knowledge, this is the first case documenting the use of these points in humans. The strength of

Conclusion

This case report demonstrates that acupuncture and physical therapy can play an important role in complete traumatic SCI recovery. Early treatment after the injury and daily treatments are the goal, but significant progress was made with twice weekly treatments started one month after injury. From a TCM perspective, treatment should focus on healing the spinal cord, promoting, and rehabilitating the function of the organs that have lost function, treating Qi and Blood deficiencies that occur

Funding

The acupuncture services were supported by the American Society of Acupuncturists’ and The European Traditional Chinese Medicine Association's Healing Heart of Humanity Project. Neither author of the case report received any specific grant from funding agencies in the public, commercial or not-for-profit sectors for writing of the report.Table 1

Acknowledgements

Translation from English to Ukrainian and from Ukrainian to English provided by Tatyana Maltseva.

Translation from Polish to English by Tania Camacho Regnier.

Orthopedist Dr. Yan Kolisnychenko, Saint Lucas Hospital, Tarnów, Poland provided valuable information.

LiMing Tseng, M. AcOM, for identifying this remarkable case and assisting in editing.

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