200 Section - Clinical Case Report: Incomplete L1 Spinal Cord Injury From Firearm Trauma - Functional Evolution and Multidisciplinary Rehabilitation

Case Diagnosis: Traumatic spinal cord injury secondary to firearm wounds neurological level L1; AIS C functional classification; incomplete paraplegia.

Case Description: A 20-year-old male patient sustained three gunshot wounds, resulting in an incomplete L1 spinal cord injury. Initial symptoms included neuropathic pain, motor impairment mostly in the lower limbs, more intense on the left side, sensory loss below L3, bowel and bladder dysfunction and recurrent tract infections. Multidisciplinary rehabilitation included pelvic physiotherapy, and radial shockwave therapy on the plantar surface. He later engaged in outpatient rehabilitation with progressive motor strengthening. Functional assessment showed proximal motor recovery, most notably in left gluteal activation, persistent distal weakness, spasticity in the right leg, autonomy in bowel and bladder management and gait impairment requiring a walker and orthosis in the right lower limb.

Discussions: The relevance of monitoring this case lies in the pursuit of rehabilitation mechanisms for patients with incomplete paraplegia, aiming to achieve well-being. Tools such as shockwave therapy, strength training, orthotics, and physical therapy, combined with active support networks and psychotherapeutic approach underlies multidisciplinary and comprehensive treatment. Spinal cord injuries affect the patient’s functionality, social participation and self-esteem. Evidence shows that spinal cord injury reduces confidence and well-being. Structured rehabilitation programs are also cost-effective for public health systems, reducing the lifetime costs associated with the condition.

Conclusions: This case demonstrates that meaningful functional recovery is achievable in incomplete L1 spinal cord injury through multidisciplinary rehabilitation and strong psychosocial support. Despite persistent challenges such as  gait, distal strength, and environmental accessibility, the patient shows continuous progress supported by resilience and structured rehabilitation strategies. This case highlights the importance of individualized, long-term rehabilitation focused on both functional independence and psychosocial well-being.