C3-7 Lami w/right side hematoma @C5-6 (Full Version)

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ckupris -> C3-7 Lami w/right side hematoma @C5-6 (February 19, 2007 6:11:00 PM)

Have a 78yo gentleman that developed a right sided hematoma at C5-6 with residual right hand dysfunction. He is 4 months post sx. He presents with 3+ wrist flexion, 2+ grip, has 3- radial extension trace ECU, mild flexor spasticity of wrist/fingers. There is also mild decrease strength right LE and increased incontinence. Am very frustrated with ortho who insists we are not doing enough with wrist extension--both ortho and wife expect 90-95% return function--is this feasible? We have been doing FES, splinting, stretching.... What else can we do?



thechampion -> Re: C3-7 Lami w/right side hematoma @C5-6 (February 22, 2007 6:22:00 PM)

try to do scapular retraction and elevation exercises. also assisted shoulder external rotation to further activate supraspitaus. I also think that muscle activation techniques may help eliminate any inhibition



KAK -> Re: C3-7 Lami w/right side hematoma @C5-6 (February 22, 2007 11:35:00 PM)

Ckupris,

I realize this is probably so obvious that you didn’t state it. You are doing exercises as well?

I imagine that the surgeon’s frustration truly may lie with the fact that there are neurological complications. You are probably the only objective non-emotionally involved party here. Nerve recovery takes TIME. If there is spasticity, LE weakness and incontinence issues there probably was spinal chord irritation/injury as well as possible nerve root injury. I think they may be a bit unrealistic, but time will tell…



ckupris -> Re: C3-7 Lami w/right side hematoma @C5-6 (March 13, 2007 4:42:00 PM)

I am in total agreement that there has been cord damage. I truly beleive I am seeing more than just nerve root palsy. His hand looks and acts like a C5-6 quad. When he attempts wrist extension he kicks in the brachioradialis and basically nothing else. They are now talking tendon transfer--How unrealistic for this gentleman. He has mild to moderate dementia and will never be able to follow thru with the post -op therapy--it's been hard enough just with what he has going on now. Anyway--thanks for the info, glad to know I am on the right track.

I recently received a new PT magazine (primere issue--Feb or Mar 07?) Not sure of the name, can't fine it anyhwere--anyway, there was an orthosis advertised that I wanted to check out to see if this might be of assistance to him. If anyone out there knows of this magazine and/or orthosis I certainly would appreciate it if you could get me the info.
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