Spinal Arteriovenous Metameric Syndrome: Role of Physiotherapy: A Case Report

Abstract

Background: Spinal arteriovenous metameric syndrome (SAMS), also known as Cobb syndrome is a rare metameric developmental disorder presenting as an extradural-intradural vascular malformation that involves bone, muscle, skin, spinal cord, and nerve roots.Case Report: An 11-year-old girl presented with history of progressive paraparesis, lower extremity sensory loss, along with bowel and bladder incontinence who was diagnosed with Cobb syndrome. She underwent endovascular embolization of one arterial feeder and two metameric components. Post embolization patient experienced further decline in muscle strength. Physiotherapy regimen was implemented for 4-5 days per week for period of two months. The patient was discharged with a home exercise programme.Result: At the time of discharge, muscle power was improved. Patient was able to walk with the help of walker. Conclusion:Spinal metameric arteriovenous syndrome is a complex nonhereditary genetic vascular disorder associated with variety of neurologic deficits. Physiotherapy management will play a major role in minimizing disability hence improve clinical outcome.