Postoperative Bilateral Lower Extremity Paralysis Following Lumbar Decompression and Fusion for Severe Spinal Stenosis: A Physiotherapy Case Report from Blue Whale DPT Project [Case ID: BW-002]

Background: Postoperative bilateral lower extremity paralysis following lumbar decompression and fusion is a rare but devastating complication of spinal surgery for severe stenosis. Evidence on structured physiotherapy rehabilitation for such cases from Pakistan is limited. Case Presentation [BW-002]: This interim case report is part of the Blue Whale DPT Clinical Database Initiative – A 3-Year Longitudinal Project (2026-2029), IRB Approved by Lyallpur Institute of Management and Sciences, Faisalabad. A 45-year-old female developed complete motor loss (0/5 MMT) in both lower limbs immediately after L4-S1 decompression and fusion for severe lumbar spinal stenosis. The case was enrolled under Blue Whale DPT Project and managed with a phased physiotherapy rehabilitation protocol including acute respiratory care, positioning, early mobilization, NMES, progressive strengthening, and gait training. Outcome: Detailed functional outcomes and 6-month follow-up will be reported in the final longitudinal analysis. Conclusion: This case highlights the critical role of early and structured physiotherapy intervention in postoperative neurological deficits and contributes to the growing clinical database of physiotherapy cases in Pakistan. Authors: M Saleem Sarang (Corresponding Author, ORCID: 0009-0008-9458-6589), Haider Ali, Dr. Kainat Ashfaq. Supervised by Dr. Amna Noor, Dr. Ali Raza, Dr. Kainat Ashfaq. Project: Blue Whale DPT, Department of Physical Therapy, LIMS Faisalabad, Pakistan. Patient informed consent obtained for publication. All identifying information anonymized. No conflict of interest. License: CC BY 4.0 International Case ID: BW-002 Keywords: Lumbar Spinal Stenosis, Postoperative Paralysis, Physiotherapy, Rehabilitation, Case Report, Blue Whale DPT