Disclosures: Daniela A. Iliescu, MD: No financial relationships or conflicts of interest

Case Diagnosis: 27 yo power lineman with C5 Incomplete Tetraplegia (AIS D) and 20% total body surface area burns as a result of high voltage electrical injury.

Case Description: 27 yo power lineman sustained high voltage electrical injuries to chest with multiple entry and exit sites including 20% total body surface area burns when he accidentally backed into a hotline. The patient initially required multiple surgical procedures for burn management. When weaned off sedation after two weeks, he was noted to be tetraplegic. Extensive evaluation found no obvious etiology and delayed SCI related to the electrical injury was suspected. His acute hospital course was complicated by respiratory failure requiring tracheostomy, dysphagia requiring PEG tube, arrhythmia, pneumonia and deep vein thrombosis.

Setting: Acute inpatient rehabilitation hospitalAssessment/

Results: The patient underwent rehabilitation four months following his injury. On admission he was completely dependent. ASIA exam performed revealed C5 Incomplete Tetraplegia (AIS D). Multi-disciplinary rehabilitation program resulted in slow but progressive improvement in self-care, mobility, and functional independence. His trach and PEG were removed. On discharge home he reached supervision for wheelchair mobility, and required significant assistance from wife and home health.

Discussion: High voltage electrical injuries resulting in Spinal Cord Injury (SCI) are very uncommon. It is not certain whether this represents primary injury to nervous tissue or secondary damage. Complete recovery is uncommon and morbidity is high given the difficulty in timely recognition and interaction of the SCI, burn severity, and multiple system involvement.

Conclusion: Our case illustrates the consequences of damage to the spine after electrical injury and the difficulty with early diagnosis as well as the importance of initiating intensive rehabilitation efforts as soon as possible due to the multitude of devastating complications after a high voltage burn.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/rehabilitation-of-traumatic-tetraplegia-and-multiple-burns-following-high-voltage-electrical-injury-a-case-report/