ABSTRACT
Atlantoaxial dislocations (AAD) are a diverse set of C1-C2 rotatory subluxations that include the inferior and superior axial facet articulations. C1-C2 segments are both covered by cranial-cervical ligaments, indicating that AAD would damage both joints. Whenever the posterior elements are missing or impaired, lateral mass screw fixation has replaced alternative posterior cervical fixation procedures as the preferred treatment for securing the sub-axial cervical spine. An increase in muscle tone, hyperreflexia, pathological reflexes, digit/hand clumsiness, and gait deviations caused by spinal cord compression at the cervical level are the most common clinical features. A 23-year-old female patient came with the chief complaint of weakness, tingling sensation, and numbness in both upper and lower limbs along with imbalance while walking. She had a history of falls which was managed conservatively. As the symptoms progressed, an MRI, a CT scan, and an X-ray of the neck were done to rule out the level of injury which revealed AAD, and the patient was operated on for C1-C2 lateral mass fixation. Post-operatively, the patient was referred to the physiotherapy department for further management. The patient's quality of life and daily functioning were positively affected after undergoing early intervention as measured by the Functional Independence Measure, Neck Disability Index, Berg Balance Scale, and Dynamic Gait Index.
ABSTRACT
The granulomatous disease tuberculosis (TB) is brought on by the bacteria Mycobacterium tuberculosis. Skeletal TB is involved in 10-35% of extra-pulmonary reported cases worldwide, with the most common kind being tuberculous spondylitis (Pott's disease). Depending upon the extent of spinal engagement, the clinical presentation may include back pain, discomfort, neurological abnormalities, as well as other clinical signs like temperature, malaise, and loss of weight. The multidisciplinary therapeutic care of Pott's illness is centered on a particular medicinal therapy, on-demand surgery, and a customized rehabilitation regimen. A 20-year-old female was diagnosed with Pott's disease following investigations in Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi (Meghe), Wardha, India. A tailored physiotherapy (PT) program was started and continued for six weeks, after which improvement in the mobility of the spine, pain relief, increased respiratory function, improved sensory function, and overall improvement in functional independence was markedly seen in the patient. The protocol included mobility, strengthening of lower limbs and core musculature, breathing, and postural correction exercises. Sensory re-education was done. Thus rehabilitation showed a great improvement in the patient and helped ease the patient's discomfort.
ABSTRACT
Oral cancer is a type of malignant neoplasia that develops in the oral cavity or lips and is commonly referred to as squamous cell carcinoma (SCC) because of its histopathology. In this report, we present to you a case of a 35-year-old male patient operated on for moderately differentiated SCC of the lateral border of the tongue and right buccal mucosa with a two-year-old case of trans-femoral amputation. Postoperatively, the patient faced issues with breathing, mouth opening and closing limitations, and painful movements of the neck and right shoulder. An intensive physiotherapy care regimen was designed and consistently implemented for two weeks to tackle the surgical results that were compromising the patient's quality of life. At the two-week evaluation, enhancements in tongue movement, mouth opening, shoulder and cervical joint movement, thoracic mobility, lower limb strength, and gait were seen, confirming the efficacy of the intended therapy. The patient was assessed before and after the rehabilitation using range of motion, manual muscle testing, the Mallampati scale, the numerical pain rating scale, the amputee mobility predictor assessment tool, and the Royapettah scoring system.
