Physical Therapy in Caudal Regression Syndrome: Case Report

Special Article – Physical Rehabilitation

Phys Med Rehabil Int. 2016; 3(2): 1081.

Physical Therapy in Caudal Regression Syndrome: Case Report

Mendelevich A* and Peralta FG

Department of Rehabilitation, Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina

*Corresponding author: Mendelevich A, Department of Rehabilitation, Instituto de Rehabilitación Psicofísica, Sanchez de Bustamante 2229 (1425), Ciudad Autónoma de Buenos Aires, Argentina

Received: April 03, 2016; Accepted: May 09, 2016; Published: May 12, 2016


Case Presentation: F.V. 5 years of age diagnosed with caudal regression syndrome, confirmed at 2 days of life through a computed axial tomography scan of the spine. At 3 months of age she was admitted to Instituto de Rehabilitación Psicofísica and she began and interdisciplinary treatment. At 5 months of age she began physiotherapy focused on the acquisition of maturational patterns in a timely manner. At 4 years of age, after orthopaedic surgeries, she achieved assisted gait with reciprocal orthoses and walker. Currently, the goal is focused on achieving a limited community gait with equipment.

Discussion: The physiotherapy is still based on empirical principles due to the limited evidence available. Literature consulted is case reports, which most of them do not describe the evolution of those who survive. Functional achievements were due to the early beginning and continuity of the treatment, prompt surgical intervention and strict compliance with post-surgical protocol, within a continent social environment.

Keywords: Physical therapy; Caudal regression syndrome; Rehabilitation; Gait

Case Presentation

Our female patient was born at 37 weeks gestational age by elective caesarean delivery on November, 2009. During pregnancy, the mother reported not having complications. The girl was born with an Apgar 9/10 and weighed 1890g. In the newborn period she required phototherapy for 48 hours and was diagnosed with a displaced fracture of the left femur of unknown aetiology, which was reduced with plaster. 2 days after birth, the diagnosis of caudal regression syndrome was established, after a CT scan of the spine was performed. The CT scan revealed the absence of the sacral vertebrae and the last two lumbar vertebrae, and partially showed the structure of the three first lumbar vertebrae with alteration and dimorphism (Figure 1). It was also evident at the level of T11 a mayor morphological alteration of the vertebral body with displacement of T11 and T12 and with almost total obliteration of the medullary canal. On the same day, a karyotype was performed, showing normal result and, on subsequent days, neurological consultations were performed which showed no distinctive features, and cardio logical consultations showed patent foramen ovale and mild valvular pulmonary stenosis. It wasn’t reported any family history.