| Peer-Reviewed

Management of a Patient with Cavernous Malformation Surgical Repair at C7-T3: A Case Report

Received: 28 September 2021    Accepted: 20 October 2021    Published: 29 October 2021
Views:       Downloads:
Abstract

Background: Cavernous malformations (CM) are rare vascular lesions occurring within the brain or spinal cord, managed using surgical and/or non-surgical interventions. Limited studies exist outlining physical therapy (PT) intervention guidelines or functional outcomes for individuals with CMs. Objective: This case outlines PT interventions that were used for a 35-year old female 6 weeks status post-surgical management of a C7-T3 spinal cord CM, and their impacts on the Timed-Up and Go (TUG), Five-Time Sit to Stand (5xSTS), and Observational Gait Analysis (OGA) functional outcome measures. Case Description: The patient participated in 41 visits of outpatient PT over 18.5 weeks focusing on compound and closed kinetic chain (CKC) interventions to improve lower extremity functional strength and coordination, gait and balance, endurance, agility, and core stabilization. Outcomes: TUG and 5xSTS times met the patient’s goals by visit 23, three weeks into treatment. OGA demonstrated improvements with steadier ambulation, a decreased base of support, increased arm swing and trunk rotation, coordination and timing, and endurance over the 18.5 weeks of treatment. Conclusion: These findings suggest that compound and CKC interventions and gait training may have potential to improve functional mobility, standing balance, and gait quality in this patient with a spinal cord CM.

Published in Rehabilitation Science (Volume 6, Issue 4)
DOI 10.11648/j.rs.20210604.11
Page(s) 53-59
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Physical Therapy, Interventions, Outcomes

References
[1] Klest B, Mutschler C, Tamaian A. Factors affecting surgery decision-making in patients with a chronic neurovascular condition [J]. J Clin Nurs, 2016, 25 (17-18): 2430-2437.
[2] Maslehaty H, Barth H, Petridis AK, Doukas A, Mehdorn HM. Symptomatic spinal cavernous malformations: indication for microsurgical treatment and outcome [J]. Eur Spine J, 2011, 20 (10): 1765–1770.
[3] Sun I, Pamir MN. Spinal cavernomas: Outcome of surgically treated 10 patients [J]. Front Neurol, 2017, 8: 672.
[4] Ohnishi YI, Nakajima N, Takenaka T, et al. Conservative and surgical management of spinal cord cavernous malformations [J]. World Neurosurg X, 2019, 5: 100066.
[5] Goyal RK, Nayak B, Maharshi R, Biswal D. Cavernous malformation in the conus medullaris: A rare report [J]. Neurology India, 2016, 64 (4): 821-823.
[6] Huntley GD, Ruff MW, Hicks SB, Yost MD, Fulgham JR. Ascending spinal cord infarction secondary to recurrent spinal cord cavernous malformation hemorrhage [J]. J Stroke Cerebrovasc Dis, 2017, 26 (4): e72-e73.
[7] Mouchtouris N, Chalouhi N, Chitale A, et al. Management of cerebral cavernous malformations: from diagnosis to treatment [J]. The Scientific World Journal, 2015, 2015: 808314.
[8] Thompson K, Mattern-Baxter K. Intensive, functional training leads to optimal outcomes in a young woman post brain stem hemorrhage due to cerebral cavernous malformation [J]. Physiother Theory Pract, 2018, 36 (6): 741-752.
[9] Oh HM, Nam TW, Kim JH, Jung TD. Effects of rehabilitation on spontaneous intramedullary spinal cord hemorrhage (hematomyelia) patient without surgery: A case report [J]. Medicine, 2018, 97 (48): 1-4.
[10] Shirley Ryan Ability Lab 2013 Timed up and go https://www.sralab.org/rehabilitation-measures/timed-and-go.
[11] Kear BM, Guck TP, McGaha AL. Timed up and go (TUG) Test: Normative reference values for ages 20 to 59 years and relationships with physical and mental health risk factors [J]. J Prim Care Community Health, 2017, 8 (1): 9-13.
[12] Bohannon RW. Test-retest reliability of the five-repetition sit-to-stand test: A systematic review of literature involving adults [J]. J Strength Cond Res, 2011, 25 (11): 3205-3207.
[13] Shirley Ryan AbilityLab 2013 Five times sit to stand test. https://www.sralab.org/rehabilitation-measures/five-times-sit-stand-test.
[14] Cullen S, Montero-Odasso M, Bherer L, et al. Guidelines for gait assessments in the Canadian consortium on neurodegeneration in aging (CCNA) [J]. Can Geriatr J, 2018, 21 (2): 157-165.
[15] Lotter JK, Henderson CE, Plawecki A, et al. Task-specific versus impairment-based training on locomotor performance in individuals with chronic spinal cord injury: A randomized crossover study [J]. Neurorehabil Neural Repair, 2020, 34 (7): 627-639.
[16] Sruthi TVK, Kumari VS, Madhavi K. To compare the closed kinetic chain exercises and open kinetic chain exercises on gait velocity, cadence, stride length and strength of knee flexors and extensors in chronic stroke patients [J]. Indian J Physiother Occup Ther, 2017, 11 (4): 212-217.
[17] Komatsu J, Sato K, Iwabuchi M, et al. Recovery of paraplegia following postoperative epidural hematomas in lumbar canal stenosis surgery by closed kinetic chain (CKC) exercises: A case report [J]. Medicine, 2019, 98 (20): e15670.
[18] Brayall P, Donlon E, Doyle L, Leiby R, Violette K. Physical therapy–based interventions improve balance, function, symptoms, and quality of life in patients with chemotherapy-induced peripheral neuropathy: A systematic review [J]. Rehabil Oncol, 2018, 36 (3): 161-166.
[19] Ferrarello F, Bianchi VAM, Baccini M, Rubbieri G, Mossello E, Cavallini MC, Marchionni N, Di Bari M. Tools for observational gait analysis in patients with stroke: A systematic review [J]. Phys Ther, 2013, 93 (12): 1673-1685.
[20] Krebs DE, Edelstein JE, Fisman S. Reliability of observational kinematic gait analysis [J]. Phys Ther, 1985, 65 (7): 1027-1033.
[21] McGinley JL, Goldie PA, Greenwood KM, Olney SJ. Accuracy and reliability of observational gait analysis data: Judgements of push-off in gait after stroke [J]. Phys Ther, 2003, 83 (2): 146-160.
Cite This Article
  • APA Style

    Thomas A. Koc, Jenna Tucker, Christopher Durante, Razija Hasanovic, Sara Gotthold, et al. (2021). Management of a Patient with Cavernous Malformation Surgical Repair at C7-T3: A Case Report. Rehabilitation Science, 6(4), 53-59. https://doi.org/10.11648/j.rs.20210604.11

    Copy | Download

    ACS Style

    Thomas A. Koc; Jenna Tucker; Christopher Durante; Razija Hasanovic; Sara Gotthold, et al. Management of a Patient with Cavernous Malformation Surgical Repair at C7-T3: A Case Report. Rehabil. Sci. 2021, 6(4), 53-59. doi: 10.11648/j.rs.20210604.11

    Copy | Download

    AMA Style

    Thomas A. Koc, Jenna Tucker, Christopher Durante, Razija Hasanovic, Sara Gotthold, et al. Management of a Patient with Cavernous Malformation Surgical Repair at C7-T3: A Case Report. Rehabil Sci. 2021;6(4):53-59. doi: 10.11648/j.rs.20210604.11

    Copy | Download

  • @article{10.11648/j.rs.20210604.11,
      author = {Thomas A. Koc and Jenna Tucker and Christopher Durante and Razija Hasanovic and Sara Gotthold and Timothy Marshall},
      title = {Management of a Patient with Cavernous Malformation Surgical Repair at C7-T3: A Case Report},
      journal = {Rehabilitation Science},
      volume = {6},
      number = {4},
      pages = {53-59},
      doi = {10.11648/j.rs.20210604.11},
      url = {https://doi.org/10.11648/j.rs.20210604.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.rs.20210604.11},
      abstract = {Background: Cavernous malformations (CM) are rare vascular lesions occurring within the brain or spinal cord, managed using surgical and/or non-surgical interventions. Limited studies exist outlining physical therapy (PT) intervention guidelines or functional outcomes for individuals with CMs. Objective: This case outlines PT interventions that were used for a 35-year old female 6 weeks status post-surgical management of a C7-T3 spinal cord CM, and their impacts on the Timed-Up and Go (TUG), Five-Time Sit to Stand (5xSTS), and Observational Gait Analysis (OGA) functional outcome measures. Case Description: The patient participated in 41 visits of outpatient PT over 18.5 weeks focusing on compound and closed kinetic chain (CKC) interventions to improve lower extremity functional strength and coordination, gait and balance, endurance, agility, and core stabilization. Outcomes: TUG and 5xSTS times met the patient’s goals by visit 23, three weeks into treatment. OGA demonstrated improvements with steadier ambulation, a decreased base of support, increased arm swing and trunk rotation, coordination and timing, and endurance over the 18.5 weeks of treatment. Conclusion: These findings suggest that compound and CKC interventions and gait training may have potential to improve functional mobility, standing balance, and gait quality in this patient with a spinal cord CM.},
     year = {2021}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Management of a Patient with Cavernous Malformation Surgical Repair at C7-T3: A Case Report
    AU  - Thomas A. Koc
    AU  - Jenna Tucker
    AU  - Christopher Durante
    AU  - Razija Hasanovic
    AU  - Sara Gotthold
    AU  - Timothy Marshall
    Y1  - 2021/10/29
    PY  - 2021
    N1  - https://doi.org/10.11648/j.rs.20210604.11
    DO  - 10.11648/j.rs.20210604.11
    T2  - Rehabilitation Science
    JF  - Rehabilitation Science
    JO  - Rehabilitation Science
    SP  - 53
    EP  - 59
    PB  - Science Publishing Group
    SN  - 2637-594X
    UR  - https://doi.org/10.11648/j.rs.20210604.11
    AB  - Background: Cavernous malformations (CM) are rare vascular lesions occurring within the brain or spinal cord, managed using surgical and/or non-surgical interventions. Limited studies exist outlining physical therapy (PT) intervention guidelines or functional outcomes for individuals with CMs. Objective: This case outlines PT interventions that were used for a 35-year old female 6 weeks status post-surgical management of a C7-T3 spinal cord CM, and their impacts on the Timed-Up and Go (TUG), Five-Time Sit to Stand (5xSTS), and Observational Gait Analysis (OGA) functional outcome measures. Case Description: The patient participated in 41 visits of outpatient PT over 18.5 weeks focusing on compound and closed kinetic chain (CKC) interventions to improve lower extremity functional strength and coordination, gait and balance, endurance, agility, and core stabilization. Outcomes: TUG and 5xSTS times met the patient’s goals by visit 23, three weeks into treatment. OGA demonstrated improvements with steadier ambulation, a decreased base of support, increased arm swing and trunk rotation, coordination and timing, and endurance over the 18.5 weeks of treatment. Conclusion: These findings suggest that compound and CKC interventions and gait training may have potential to improve functional mobility, standing balance, and gait quality in this patient with a spinal cord CM.
    VL  - 6
    IS  - 4
    ER  - 

    Copy | Download

Author Information
  • School of Physical Therapy, Kean University, Union, United States of America

  • School of Physical Therapy, Kean University, Union, United States of America

  • Prostaff Physical Therapy, Nutley, United States of America

  • School of Physical Therapy, Kean University, Union, United States of America

  • School of Physical Therapy, Kean University, Union, United States of America

  • School of Physical Therapy, Kean University, Union, United States of America

  • Sections