gms | German Medical Science

15th Congress of the European Forum for Research in Rehabilitation (EFRR)

15.04. - 17.04.2019, Berlin

Rare cause of low back pain, late diagnosis, long rehabilitation – case report

Meeting Abstract

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  • corresponding author presenting/speaker Eszter Herczeg - National Institute for Medical Rehabilitation, Budapest, Hungary
  • Anna Nemedy - National Institute for Medical Rehabilitation, Budapest, Hungary
  • Judit Donath - National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
  • Gabor Fazekas - National Institute for Medical Rehabilitation, Budapest, Hungary

15th Congress of the European Forum for Research in Rehabilitation (EFRR). Berlin, 15.-17.04.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. Doc087

doi: 10.3205/19efrr087, urn:nbn:de:0183-19efrr0870

Veröffentlicht: 16. April 2019

© 2019 Herczeg et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Background: In all patients who receive anticoagulant therapy there is always a risk for bleeding.

Aim: Authors report the case history of a 66-year-old woman, who became paraparetic because of a rare reason of acute low back pain.

Method: This patient was entered to a rheumatic ward due to low back pain and atypical numbness of lower extremities. Her symptoms deteriorated to severe paraparesis.

She had got anticoagulant therapy because of artificial aortic valve. At the admission to hospital her INR was 3,9. After rapid progression of paraparesis MRI showed an intraspinal bleeding in the altitude of ThX-LV. It was evacuated. After the operation the muscle strength improved around hip and knee, but plegia was still present in both ankles. In addition, the patient had hypaesthesia on the field of radices Th12-L5, anaesthesia of S1-5 also faecal and urinal incontinence.

At the admission to the rehabilitation ward the patient could sit up in the bed, and had static balance, but could not stand. Transfer to the wheelchair was not possible.

During physiotherapy she made muscle strengthening, practiced transfer to the wheelchair, making exercises for preparing walking and stair climbing.

Results/findings: At discharge she could walk alone 40–50 meters with rollator, for longer distances she needed a wheel chair. She could climb up 40 stairs holding the shackle. Because of urinal incontinence she was educated to execute intermittant catheterisation.

Discussion and conclusions: In conclusion it must be emphasized that in patients receiving anticoagulant therapy, low back pain can arise from haematoma and the quick diagnose can improve the outcome of rehabilitation.


References

1.
Toi H, Matsubara S, Watanabe S, Yamashita T, Uno M. Paraspinal arteriovenous fistula presenting with subarachnoid hemorrhage and acute progressive myelopathy - case report. Neurol Med Chir (Tokyo). 2011;51(12):846-9.