Name: Abdulaziz Alghamdi                  
Sex: Male
Country: Saudi Arabia
Age: 25
Diagnoses: Spinal cord injury (SCI), urinary tract infection
Admission Date: 2011-12-05
Days Admitted to Hospital: 58

Abdulaziz was involved in an accident in July 2010. It affected the movements and sensation in his arms and legs. He was sent to a local hospital where it was revealed that there was a fracture of the spinal cord C4. After the surgery, the sensation in the arms, as well as their movement ability was gradually restored. There was no obvious improvement in the legs. The movement in both arms was limited and the legs were unable to move at all.

There was skin damage with a resulting scar about 0.7cm*0.7cms long. The skin pigmentation around the scar was reduced (the skin damage was healing).
During the nervous system examination, the shrugging strength of the shoulders was weak and the left side was more severe. The adduction strength of the right upper limb's proximal-end was level 1, the adduction strength of the right forearm was level 3-, the abduction strength of the forearm's proximal-end was level 3+, and the abduction strength of the forearm's distal end was level 1. The right wrist was able to do the dorsiflexion movement. The abduction strength of the left upper limb's proximal-end was level 2-, and the adduction strength was level 0. The adduction strength of the forearm was level 1, and the abduction strength was level 0. The left wrist was unable to do the dorsiflexion movement. None of the fingers on either hand had movement. The muscle strength of both lower limbs was level 0. The muscle tone of the left upper limb was increased. The muscle tone of the right upper limb and both lower limbs was almost normal. The left wrist had postural clonus. There was no atrophy in the upper or lower limbs. The tendon reflexes of the right upper limb were normal. The biceps reflex of the left upper limb was reduced. The shallow sensation below the cervical spinal segment 4 was diminished. The shallow sensation in the left upper limb was diminished more severely than the other limbs and torso. There was pallhypesthesia below the right cervical vertebrae segment 5. The vibration sensation between the left cervical vertebra segment 5 and thoracic vertebra segment 2 was diminished. The vibration sensation below the left thoracic vertebra segment 3 was diminished and was more obvious below the presacral 1. The stereognosis, graphic sensation in the left foot and left upper limb was diminished. The two-point discrimination below the right lumbar vertebrae was weakened, and between the cervical vertebra segment 2 and cervical vertebrae segment 5, and below the lumbar vertebra segment 5 were also weakened, the others were normal. The bilateral Hoffmann's sign was positive. The left side Babinski's sign was positive and the right side Babinski's sign was probable positive. Abdulaziz was unable to finish the finger-to-nose-test, the heel-knee-shin test or the rapid rotation test.

We initially gave Abdulaziz a complete examination and he was diagnosed with a spinal cord injury and urinary tract infection. Then we proceeded with the autologous stem cell treatment. He also received treatment to control the infection. This was combined with daily physical rehabilitation training.

After the completion of the stem cell treatment, the muscle strength of the lower back and abdomen had increased. Abdulaziz has better control of his body movements, but still has problems shifting his body to the left or to the right. The shoulders have stronger shrugging strength and the muscle strength of both upper limbs has increased. The adduction strength of the right upper limb's proximal-end has reached level 3. The adduction strength of the right forearm has reached level 3+, and the abduction strength has reached level 4. The wrist can do the dorsiflexion movement. The adduction strength of the left upper limb's proximal-end is level 2. The abduction strength of the forearm's proximal-end is level 2. The abduction strength of the forearm's distal end is level 1+. The left thumb has slight movement, but the other fingers on the left hand have no movement. There are muscle contractions in the lower limb's proximal-end. The sensation in the chest and lower back has improved. Abdulaziz was put on a long-term indwelling catheter. He had a urinary tract infection when he was admitted but the infection was controlled after the anti-inflammatory treatment. Abdulaziz was satisfied with the treatment results and expressed his gratitude to the doctors and nurses. The entire staff hopes Abdulaziz continues to improve.