8 YR OLD GIRL - Not able to move lower limbs after Road ACCIDENT

[refine3456]

In a road accident my friend died and his 8 yr old daughter injured, and now she is unable to move lower limbs.(Paralyzed)

This accident happened in india, here are some paragraphs i picked from here diagnosis report.

Please kindly need advice on treatment options available here in US.
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Diagnosis: Unstable Ts + Tc Thoracic vertebra fracture with traumatic
paraplegia with neurogenic bladder.

Left orbital floor blow - out fracture, L7-MC complex fracture.
Bilateral nasal fracture.
---------------------------------------------

Surgery: Stabilisation of thoracic vertebrae fracture with
instrumentation & fusion.

ORIF of facial fractures.

Clinical Examination
Weight : 30 Kgs

CVS : S1 52 normal, no distant heart sounds
RS : Air entry decreased over right side.

ABDOMEN : Soft, distended, mild tenderness.
CNS: Patient Awake but drowsy.

DTR - Not elicitablein lower limbs

GENITALS : Normal.
GENERAL APPEARANCE : Skin - Lacreation + over left eye & base of nose

Eyes - Swelling left eye +.
Ears - Normal.
Nose - No bleeds.
Mouth - Blood clots +.
Throat - Normal.
Neck- Normal stabilized with collar.

Functional evaluation(ability to do routine activities:)Not able to move lower limbs.



Unstable T5 + T6 Thoracic vertebrae fracture with traumatic paraplegia.
MRI spine done showed burst fractures at T5 + T6 with retropulsion of the fracture
segments narrowing the spinal cord & causing compression with resultant
paraplegia.

Surgery Done :- Stabilization of thoracic vertebrae fracture with instrumentation
and fusion.



Infection:
Patient was intubated & had sustained trauma she was started on emperic
antibiotic with eefaperazon & Sulbactam along with targocid as cultures were
sterile they were stopped . During her course of stay in hospital she developed
asymptomatic E.coli bacteria & was treated with Tab.Nitrofurantion (risk
factor- intermittent catheterization of neurogenic bladder) .
Currently she is on CIC for the same.


1. - Patient was shifted from PICU on ventilator.
-Shifted from bed to OT table, prone position without disturbing
vertebrae fracture.
-Back thoroughly washed. An area of about 5cm in diameter dark skin
region noted. ( ? Pressure sore )
-Under 1 .1 level marked.
-Posterior midline longitudinal incision Deep fascia incised.

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Thank you all very much for the helpful info.

[allmymarbles]

It is my understanding that India has some very fine doctors.In fact many Americans go there for treatment. If her spinal cord was severely damaged I do not know what can be done about the paralysis. I can imagine how badly you fell for the little girl. It is a terribly sad situation.

[seemural]

Dr. Fraser Henderson in Bethesda Maryland, USA is the best spine dr that I know of. I don't know anything about the quality of medical care in India. I will pray for this family. My heart goes out to them.