Onset of a Charcot spinal arthropathy at a level lacking surgical arthrodesis in a paraplegic patient with traumatic cord injury

Eur Spine J. 2010 Jul;19 Suppl 2(Suppl 2):S83-6. doi: 10.1007/s00586-009-1055-0. Epub 2009 Jun 7.

Abstract

The study design included a case report of Charcot spinal arthropathy treated with posterior and anterior spinal instrumentation. The objective of the study was to report an unusual case of Charcot spinal arthropathy as a late complication of traumatic spinal cord injury in a patient previously treated with a long posterior thoraco-lumbar instrumentation and postero-lateral fusion. A 33-year-old man with T10-T11 complete paraplegia presented with focal low back pain, kyphotic deformity of the lumbar region with L2-L3 fracture-dislocation and hardware failure. Our treatment consisted of a circumferential arthrodesis performed with a combined anterior and posterior approach. Spinal stabilization was achieved and the patient was pain free and able to resume a sitting posture. This report suggests that the development of a Charcot spine arthropathy must always be considered as a late complication of a spinal cord injury. Moreover, we would emphasize the fundamental role of a strict clinical and radiological follow-up in order to detect an early Charcot spine complication.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Arthropathy, Neurogenic / etiology*
  • Arthropathy, Neurogenic / physiopathology
  • Equipment Failure*
  • Humans
  • Internal Fixators / adverse effects*
  • Kyphosis / diagnostic imaging
  • Kyphosis / etiology*
  • Kyphosis / pathology*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery
  • Male
  • Radiography
  • Reoperation
  • Spinal Cord Injuries / complications*
  • Spinal Cord Injuries / physiopathology
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / pathology
  • Spinal Fractures / surgery
  • Thoracic Vertebrae / injuries
  • Thoracic Vertebrae / pathology
  • Thoracic Vertebrae / surgery
  • Treatment Outcome
  • Zygapophyseal Joint / innervation
  • Zygapophyseal Joint / physiopathology