64-Year-Old Woman Recovers from Cervical Spinal Cord Injury After 10-Day Treatment

Spinal cord injuries can arise unexpectedly and severely impact a person's quality of life. This case highlights the journey of a 64-year-old female patient who developed acute cervical spinal cord dysfunction following an upper respiratory infection. Initially presenting with progressive limb weakness and numbness, she was promptly diagnosed with inflammatory cervical myelopathy. Thanks to timely hospitalization, comprehensive medical intervention, and supportive care, her neurological symptoms began to improve within 10 days. This article explores her diagnosis, treatment plan, recovery progress, and essential post-discharge recommendations—offering valuable insights for patients and caregivers navigating similar conditions.

Understanding Inflammatory Cervical Myelopathy

Inflammatory myelopathy is a condition characterized by inflammation of the spinal cord, often triggered by infections, autoimmune responses, or post-vaccination reactions. When this inflammation affects the cervical (neck) region, it can lead to significant motor and sensory deficits in the arms and legs. Early recognition and aggressive treatment are crucial to prevent permanent damage, especially since the condition may progress to involve breathing muscles if not managed properly.

Patient Overview

Age & Gender: 64-year-old femaleDiagnosis: Cervical spinal cord injury due to inflammationHospital: The Second Affiliated Hospital of Harbin Medical UniversityDate of Admission: January 2022Treatment Duration: 10 days inpatient, followed by outpatient rehabilitationPrimary Symptoms: Progressive quadriparesis (weakness in all four limbs), numbness, difficulty walking

Initial Clinical Presentation

The patient reported a history of upper respiratory tract infection one week prior to symptom onset. Two days before seeking medical help, she began experiencing bilateral leg weakness, initially mild enough that she could still lift her legs off the bed. She attributed it to fatigue and did not seek immediate care. However, as her condition worsened—progressing to an inability to lift her limbs—and was accompanied by arm numbness and weakness, she became increasingly anxious and visited the emergency department overnight.

Emergency blood tests revealed normal potassium levels, ruling out hypokalemia as a cause. Given the rapid progression of neurological symptoms without altered consciousness, clinicians suspected spinal cord involvement. After discussing the risks and necessity of further evaluation with the family, the patient was admitted for urgent diagnostic testing and monitoring.

Diagnostic Workup and Findings

A thorough in-hospital assessment included MRI of the spine, lumbar puncture, blood work (complete blood count, electrolytes, liver and kidney function, cardiac enzymes), and arterial blood gas analysis. Imaging played a pivotal role: MRI scans showed abnormal signals at the C3–C4 vertebral level, indicating spinal cord inflammation and instability. These findings, combined with clinical signs such as reduced muscle strength (grade 3 in upper limbs, grade 2 in lower limbs), confirmed a diagnosis of inflammatory cervical myelopathy.

Arterial blood gas results were reassuring, showing 98% oxygen saturation and stable vital signs (temperature: 36.9°C, BP: 140/80 mmHg, heart rate: 70 bpm, respiratory rate: 17 breaths/min). Importantly, there was no evidence of respiratory muscle involvement, which significantly improved the prognosis.

Comprehensive Treatment Strategy

Given the risk of ascending myelitis—a potentially life-threatening complication affecting respiration—an aggressive multidisciplinary approach was initiated immediately upon admission:

• Oxygen therapy to ensure optimal tissue perfusion
• Intravenous methylprednisolone sodium succinate for high-dose corticosteroid pulse therapy to reduce inflammation
• Citicoline sodium injection to support neural metabolism
• Mecobalamin injections and oral vitamin B1 to promote nerve regeneration
• Glycerol fructose sodium chloride solution to alleviate spinal cord edema
• Erigeron breviscapus injection to enhance microcirculation

This combination aimed to halt disease progression, protect neural tissue, and create a favorable environment for recovery. The patient responded well, with no deterioration observed during the critical early phase.

Recovery Progress and Clinical Outcomes

Over the course of 10 days, the patient's condition steadily improved. For the first three days, there was little change in motor function. However, on day four, she reported decreased numbness and increased strength in her feet, particularly noting better dorsiflexion. By the end of the treatment period, both upper and lower limb strength had visibly improved, and sensory disturbances were less pronounced.

Her stable vital signs and lack of respiratory compromise indicated that the spinal inflammation had not spread to higher cervical segments. With symptom stabilization and functional improvement, she met discharge criteria. The treating team emphasized the importance of continuing rehabilitation to maximize long-term outcomes.

Post-Discharge Care and Rehabilitation Guidelines

While hospitalized care addressed the acute phase, ongoing recovery depends heavily on structured rehabilitation and vigilant self-care. Key recommendations include:

Physical Rehabilitation

Patients should engage in regular physical therapy under professional supervision. Techniques such as passive joint mobilization, positioning limbs in functional alignment, massage, acupuncture, and electrotherapy can help maintain muscle tone, prevent contractures, and stimulate nerve recovery.

Medication Management

The patient continued on corticosteroid therapy after discharge, requiring close monitoring for potential side effects such as gastrointestinal bleeding (e.g., black stools or vomiting blood), elevated blood pressure, hyperglycemia, or hip pain suggestive of avascular necrosis.

Lifestyle and Preventive Measures

Avoiding infections remains paramount. Patients are advised to practice good hygiene, dress appropriately during weather changes, and avoid crowded places during flu seasons. A balanced, easily digestible diet rich in vitamins supports healing and immune health.

Follow-Up Schedule

A follow-up appointment was scheduled for one month post-discharge to evaluate neurological recovery, adjust medications, and assess the need for continued or modified rehabilitation. Regular blood tests were also recommended to monitor electrolyte balance, including potassium and calcium levels.

Clinical Insights and Prevention Tips

Inflammatory spinal cord injuries remain challenging due to their unpredictable onset and complex underlying mechanisms. While the exact cause isn't always clear, preceding viral infections—like the upper respiratory illness seen in this case—are common triggers. Autoimmune activation following infections or vaccinations may play a role, underscoring the importance of managing immune health wisely.

Prevention strategies include:

• Timely treatment of infections like colds or gastroenteritis
• Vaccination only when appropriate and medically advised (avoiding vaccines in contraindicated individuals)
• Maintaining overall wellness through nutrition, sleep, and stress management

Early medical attention for unexplained limb weakness or numbness is critical—delays can result in irreversible damage. Public awareness and physician vigilance are key to improving outcomes in these rare but serious neurological events.