Wazir Khan Muhammad- Sequelae of trauma to spinal cord(Pakistan)

Name: Wazir Khan Muhammad     
Sex: Male
Country: Pakistan
Age: 28
Diagnoses: Sequelae of trauma to spinal cord, severe pressure sores (sacrococcygeal region), infection, gangrene in both of the big toes, hypothyroidis, and high plasma hyperhomocysteinemia.

Admission Date: 2010-04-09
Days Admitted to the Hospital: 42

Wazir suffered from a gunshot wound 8 months ago. He was presented with sensory and motor dysfunction, bowel and bladder dysfunction, and a decrease in feeling in the umbilical region for the past 8 months. Wazir was sent to the hospital for treatment immediately, but he was only treated for the trauma and the abdominal gunshot wound. The bullet in the vertebral column was not dealt with.

Post trauma, there was a loss of sensation and movement below the 10th thoracic vertebra. The local hospital gave Wazir physical rehabilitation training, but there was no real improvement to his condition. Wazir was bedridden for a long time and he suffered from pressure sores in his feet and severe bedsores in the sacrococcygeal region.

Wazir learned about how the medical staff at our hospital had previous experience with treating patients with various spinal cord injuries by using the stem cell treatment, from researching the Internet. A decision was made to come to our medical center to see if his spinal cord injury could also be successfully treated.

Admission PE:
Bp: 123/79mmHg; Hr: 88/min. Wazir's nutrition was normal. The heart and lungs were also normal. He received an enterostomy in the right middle section of the abdomen. Wazir had surgical scars on the right shoulder blade, left shoulder and abdomen, as a result of the surgery he received after his gunshot wound. There was a 2cm*2cm pressure sore on the right heal, and both big toes had gangrene, the big toe on the right foot had more severe gangrene. There was a 15cm*3cm bedsore in the sacrococcygeal region. The surface area of the wound was red, had a flask-like sinus tract, the caliber was about 2cm*3cm, 2cm deep inside the cranium.

During the examination of the nervous system, Wazir was alert and his speaking ability was normal. His memory, calculation and orientation abilities were all normal. Both pupils were equal in size and round, the diameter was 3.0mm. Both eyeballs could move freely and the pupils reacted normally to light stimulus. The forehead wrinkle pattern was symmetrical. The tongue was centered in the oral cavity and the teeth were shown without deflection. Wazir could move his neck normally. The muscle tension of both upper limbs was normal; the muscle strength was level 5. The muscle tension of both lower limbs was low; the muscle strength was level 0. The tendon reflexes of both upper limbs were normal; the bilateral patellar tendon reflex was not elicited, the bilateral abdominal reflex could not be examined. Above the 10th thoracic vertebra, Wazir's pain sensation was normal; below the 10th thoracic vertebra, there was no pain sensation. The bilateral Hoffmann's sign and Rossilimo's sign were negative. The palmomental reflex was negative. The coordinated movement examination of both the upper limbs was normal, while both lower limbs could not cooperate with the coordinated movement examination.

We initially gave Wazir a complete examination, and he was diagnosed with sequelae of injury of spinal cord, severe pressure sores (sacrococcygeal region), infection, and gangrene in both big toes. After the diagnoses were given, we proceeded with the self stem cells activation treatment to repair the damaged neurons. Wazir received treatment to improve the blood circulation to increase the blood supply to the damaged neurons. Then we corrected the thyroid function and plasma homocysteine. We also gave him daily physical rehabilitation, anti-inflammatory treatment and regularly changed the dressing to relieve the pressure sores.

With the careful nursing and professional therapy, Muhammad's bedsores have decreased to a size of approximately 2.5cm*3cm at the shinbone coccyx and the blood circulation is good. The far-end size is 0.3cm*4cm,the surface of the wound area is now pink and the flask-like sinus tract was reduced to a size of 1cm*2cm, 4-5cm deep to caudal. The surface of the wound had fresh granulation tissue, the exudation and the odor are not severe. The sacrococcygeal bone was exposed, gray colored. The surface of the bone was rough and picked out 2 sequestrums from it. Wazir's middle and lower abdomen area now has deep sensation.

Wazir has expressed to us that he is satisfied with the results of the treatment. The muscle strength of the shoulders and the lower limbs has shown good improvement. Wazir can now take care of himself to a great extent. Everyone at Wu Stem Cells Medical Center is hopeful that Wazir's condition will continue to improve now that he is back home.