Early Functional Improvement in American Spinal Injury Association Impairment Scale Grade C (AIS C) Non-Traumatic Spinal Cord Injury Following Staged Thoracic Decompression and Inpatient Rehabilitation: A Case Report

Non-traumatic spinal cord injury (NTSCI) may result from degenerative spinal conditions, including spinal stenosis and multilevel disc herniation, and can cause substantial motor, sensory, and functional impairment.We present a 33-year-old man with NTSCI secondary to severe thoracic spinal stenosis and multilevel disc herniation.Before the initial surgical intervention, the available neurological examination documented 5/5 upper-extremity strength and 4/5 strength in the bilateral lower extremities.Sensation was impaired below a thoracic level, and hyperreflexia and other findings consistent with thoracic myelopathy were documented.Gait was impaired, while bowel and bladder function remained preserved.A complete segment-by-segment International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examination and formal preoperative ASIA Impairment Scale (AIS) classification were not documented; therefore, a preoperative lower-extremity motor score could not be reliably calculated.During a 26-day inpatient rehabilitation stay, the patient progressed from non-ambulatory status with extensive assistance for mobility and self-care to assisted ambulation of 170 feet with a front-wheeled walker and contact guard assistance, accompanied by improvements in transfers, wheelchair mobility, and activities of daily living.Although objective neurological findings provide important context for the patient's course, complete serial ISNCSCI motor and sensory scores and standardized rehabilitation outcome measures were unavailable; therefore, the principal documented outcome is functional improvement rather than quantified neurological recovery.The patient's trajectory was likely multifactorial, reflecting surgical relief of mechanical compression, early postoperative and spontaneous neurological recovery, preserved motor pathways associated with motor-incomplete SCI, psychological engagement, and rehabilitation-facilitated functional adaptation.