Shortening osteotomy for the treatment of spinal neuroarthropathy following spinal cord injury. A case report and literature review.
The development of Charcot's arthropathy of the spine secondary to spinal cord injury is rare and reports in the literature concerning it's surgical management are limited. Arthrodesis is the recommended treatment for painful and unstable neuropathic joints. Traditionally this involves extensive debridement of the affected joint with anterior and posterior instrumented fusion and autograft to bridge the defect. This paper reviews the reported surgical management of post-traumatic spinal neuroarthropathy in the recent literature and presents a case where sound fusion was achieved by a shortening osteotomy and end-to-end apposition of the fresh bleeding bony surfaces of the adjacent vertebral bodies. The patient reported marked improvement of symptoms post-operatively without any complications of surgery. CT scan at 13 months confirmed successful bony union. Clinical follow up was completed to 3 years. This technique eliminated the need for anterior surgery and extensive autograft thus reducing surgical morbidity.
Thomason
Katharine
K
The Spinal Unit, Royal Deven and Exeter Hospital, Royal Devon and Exeter NHS Trust, Barrack Road, Exeter, EX2 5DW, UK.
Emran
Ihab M
IM
Chan
Daniel
D
D000063:Accidents, Traffic; D000328:Adult; D001174:Arthrodesis / Q000295:instrumentation / Q000379:methods*; D001177:Arthropathy, Neurogenic / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D001416:Back Pain / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D016268:Internal Fixators; D007738:Kyphosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D008297:Male; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology; D020886:Somatosensory Disorders / Q000150:complications / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000150:complications*; D013122:Spinal Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D016103:Spinal Fractures / Q000150:complications / Q000473:pathology; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods; D013131:Spine / Q000294:innervation / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D016474:Weight-Bearing / Q000502:physiology; D021801:Zygapophyseal Joint / Q000294:innervation / Q000473:pathology / Q000601:surgery*