SIGNIFICANT RECOVERY OF MOTOR FUNCTION IN A PATIENT WITH COMPLETE T7 PARAPLEGIA RECEIVING ETANERCEPT

Objective: To report an unusual case of significant motor recovery in a patient with T7 complete paraplegia treated with etanercept for ankylosing spondylitis. Design: Case report. Results: During the first year sensory-motor recovery occurred, and the American Spinal Injury Association Impairment Scale (AIS) improved from A to D. Conclusion: Initial spinal cord injury is a direct consequence of the trauma. It triggers a series of molecular and cellular reactions leading to "secondary damage". Tumour necrosis factor a is a key inflammatory mediator that is increasingly expressed after spinal cord injury. Etanercept is a recombinant dimer of human tumour necrosis factor a receptor protein that inhibits tumour necrosis factor a activity. It has shown an immunomodulatory effect in mice after traumatic spinal cord injury. It significantly reduced the posttraumatic spinal cord inflammation and the perilesional area. In this case, a reduction in the secondary damage, due to etanercept treatment could explain the significant motor recovery, which is unusual since 80% of AIS A lesions remain complete.