Integrative treatment of paralytic small intestine following acute cervical cord injury: A case report.

BACKGROUND

A patient developed paralysis of the small intestine following an acute traumatic hyperextension cervical spinal cord injury attributed to the ossification of the posterior longitudinal ligament (OPLL) C3-C6. The persistent ileus finally resolved utilizing Kampo medications (traditional Chinese therapy) consisting of both bukuryoin (TJ-69) and hangekobokuto (TJ-16).

CASE DESCRIPTION

A 63-year-old male became acutely quadriplegic secondary to a hyperextension injury incurred during a fall. Radiographic studies confirmed mixed OPLL extending from C3-C6 resulting in marked cord compression, there was a clear spinal cord contusion. His neurological status using the American Spinal Injury Association (ASIA) Scale was Grade "A;" there were was complete motor and sensory loss below the C5 level. After a C3-C6 expansive laminoplasty, the ASIA scale improved to Grade B. However, he then developed a persistent small intestine ileus resulting in marked abdominal distention. When conventional therapies failed to resolve the problem, Kampo medicines, consisting of both bukuryoin (TJ-69) and hangekobokuto (TJ-16), were administered. The ileus improved within 2 days and fully resolved within the 1 postoperative week.

CONCLUSION

The utilization of Kampo medications, consisting of both bukuryoin (TJ-69) and hangekobokuto (TJ-16), or the combined bukuryoingohangekobokuto (TJ-116) effectively resolved a postoperative paralytic small bowel ileus following a cervical laminoplasty performed in a quadriplegic patient.

KEYWORDS

Acute cervical cord injury, Cervical ossification of the posterior longitudinal ligamentOPLL, Complication management, Integrative medicine, Paralytic small intestine.