[Paraplegia in manual therapy. A case report]

Area of Science:

• Neurosurgery
• Orthopedic Oncology
• Radiology

Background:

• Giant cell tumors (GCTs) are typically benign but can cause significant bone destruction.
• Spinal tumors, if undiagnosed, pose a risk of neurological compromise.
• Manual therapy, while beneficial for some conditions, carries risks if underlying pathologies are not excluded.

Observation:

• A case of complete paraplegia is reported in a patient who underwent manual therapy for a dorsal spine condition.
• The patient had a giant cell tumor of the dorsal spine, which was not detected prior to manual therapy due to the absence of radiological examination.
• This led to a malpractice trial concerning the indication of manual therapy and the preventability of paraplegia.

Findings:

• Manual therapy was deemed inappropriate in this case due to the undiagnosed spinal tumor.
• While retrospective determination of preventability was impossible, it is probable that paraplegia could have been avoided.
• Early radiological detection followed by prompt surgical intervention is likely crucial for preventing neurological deficits from spinal GCTs.

Implications:

• Highlights the critical importance of radiological assessment before initiating manual therapy for spinal conditions.
• Underscores the potential for severe neurological injury from spinal tumors when diagnosis is delayed.
• Emphasizes the need for a thorough diagnostic workup to ensure patient safety and optimize treatment outcomes in spinal pathologies.