Clinical Treatment of a Patient with Spinal Stenosis Presenting as a Spinal Cord Injury: A Case Report

Background: Spinal stenosis can be found anywhere in the vertebral column with cervical and lumbar being the most common locations. Typically, spinal stenosis is due to a congenital or degenerative process as the patient ages and is a common condition seen in outpatient physical therapy clinics. Treatment of spinal stenosis is usually performed pharmacologically with NSAIDS, conservatively with physical therapy, or surgically with decompressive surgery and spinal fusion. The purpose of this case report is to describe the positive outcomes of conservative physical therapy treatment for spinal stenosis. Case Description: This case involves a 54-year-old female with a several year history of cervical, thoracic, and lumbar spinal stenosis resulting in continued lower extremity weakness from decompression surgery leading to signs resembling a spinal cord injury. She had spent time at a major Midwest rehabilitation hospital prior to her transfer to this rehabilitation skilled nursing facility. Intervention: Treatment focused on the use of biofeedback training, repeated sit to stands, and aquatic therapy. Intensive therapy was performed for 60 minutes a day for 5 days per week. Outcome Measures: The main functional outcome measures used in this study were muscle activation of the quadriceps and gluteus maximus as measured by the Chattanooga Intellect biofeedback system, repetitions completed and seat inclination during the repeated sit to stands, and total time spent walking on the underwater treadmill, speed of ambulation, and depth of water. Discussion: In only eight weeks of treatment, we were able to make progress towards more independent living by increasing overall strength. This suggests that the combination of these three interventions is well tolerated and led to positive outcomes in this case.