Elective bilateral above the knee amputation in T4-complete spinal cord injury: a case report

Study design: This case study outlines an individual with a T4 complete level injury with Ashworth scale grade 4 spasticity of the lower extremities. Objective: To discuss a treatment option for this individual with spinal cord injury (SCI) who had a variety of functional impairments, disabilities, and medical complications based on his level of injury. Setting: The department of physical medicine and rehabilitation at Kaiser Permanente in San Diego, California. Methods: The patient's lower extremity spasticity contributed to pressure ulcers of his hips and feet as well as comfort and functional issues with his instrumental activities of daily living (ADLs). After failing medical therapies to control spasticity, and much discussion, bilateral above the knee amputations were performed. Results: The patient had resolution of his SCI medical complications and a marked improvement in his quality of life. Conclusion: This case study discusses a treatment option for a SCI-complete patient whose lower extremities had become detrimental to his function and general well being.