Physical Therapy Management and Treatment of a Patient with Post-traumatic Syringomyelia

Background: Symptomatic post-traumatic syringomyelia (PTS) is a relatively uncommon but potentially serious result of trauma to the spinal cord. PTS can have a significant long-term impact on function and mobility even with surgical management. The purpose of this case report is to describe an outpatient physical therapy management of an individual following surgical management of recurrent spinal cysts associated with PTS. Case Description: The patient was a 39-year-old male who presented to physical therapy after the most recent of several shunting procedures to prevent the development of a syrinx in the spinal cord. The patient had a history of recurrent post-traumatic spinal arachnoid cysts and syringomyelia secondary to a past motor vehicle accident. The interventions for the patient included robotic assisted gait training via the Lokomat, functional electric stimulation cycling, stretching, and overground gait training. Outcomes: From the initial evaluation, the patient demonstrated improvement in the Kansas University Acute Care Functional Outcomes Tool score (11/28 to 19/28) and the Tinetti (1/28 to 12/28). The patient also required less assistance with transfers and standing, as well as progressing from being non-ambulatory to ambulating with an assistive device and minimal assistance from the physical therapist. The patient also demonstrated improvements in functional ambulation outcome measures. Discussion: There is currently limited research describing the use of physical therapy in patients with PTS, which can have a significant impact on the long-term function of patients. This 39-year-old patient with PTS demonstrated positive outcomes in terms of improved independence, function, and ability to ambulate over the course of his care. Further research evaluating the effectiveness and potential benefit of physical therapy interventions is needed in individuals with PTS.