Integrated Orthotic–Prosthetic Management in a Patient With Spinal Cord Injury and a Right Below-Knee Prosthesis: A Retrospective Case Study

Concurrent cervical spinal cord injury and lower-limb amputation occur in only about 4% of patients, creating unique rehabilitation challenges with limited clinical guidance, therefore the purpose of this retrospective case study was to evaluate the clinical effectiveness and functional impact of a joint-and-thigh corset style orthosis for a patient with an incomplete C3–C6 SCI and right transtibial amputation who presented with severe spasticity, impaired lower-extremity control, and functional quadriplegia. By examining four consecutive orthotic-prosthetic iterations, this study identified how orthotic and prosthetic rigidity, socket contouring, and donning complexity directly influenced tone management, prosthetic tolerance, and the patient’s ability to achieve supported standing and short-distance ambulation. Findings highlight that excessive socket contouring exacerbated spasticity, while controlled rigidity and simplified donning pathways enhanced functional stability and comfort. This case addresses an important gap in managing complex neuromuscular and musculoskeletal impairments, providing practical clinical insights for interdisciplinary teams working with medically complex patients requiring multi-level stabilization.