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

Yoshitaka Hirano; Hideya Isai; Akinori Onuki; Kazuo Watanabe

doi:10.25259/SNI_62_2020

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

Surg Neurol Int. 2020 Apr 25:11:80. doi: 10.25259/SNI_62_2020. eCollection 2020.

Authors

Yoshitaka Hirano^{1

2}, Hideya Isai^{2

3}, Akinori Onuki¹, Kazuo Watanabe¹

Affiliations

¹ Department of Neurosurgery, Southern TOHOKU Research Institute for Neuroscience, Yatsuyamada, Koriyama, Fukushima.
² Research Group for Kampo Medication Based on Modern Science.
³ Director, Hidaka Tokushukai Hospital, Shizunai Kosei, Shin-Hidaka, Hidaka, Hokkaido, Japan.

Abstract

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^st 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.

Publication types

Case Reports