The early management of varus feet in myelomeningocele.
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After an injury to the central nervous system, physical and cognitive impairments and disabilities often abate. These gains may be partly mediated by mechanisms that allow reorganizing of the structure and function within gray and white matter. The potential to enhance neurologic recovery by manipulating the brain and spinal cord must now be considered in clinical practice. Today's rehabilitation routines may not encourage maximum recovery. Indeed, some commonly used physical and pharmacologic methods could inhibit the restoration of motor activities such as walking. On the other hand, therapies that use our expanding knowledge of neuroplasticity could lead to better results for patients.
A 31-year-old man had manipulative therapy because of pain in the neck, the left shoulder and the left arm. Immediately after cervical traction he developed neurological symptoms. Clinical investigation led to the diagnosis of cervical myelopathy. The patient had a rather narrow cervical canal. Six weeks after treatment with external fixation and corticosteroids the situation had improved markedly, with remaining hypesthesia in both hands and the right leg.
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