title: Onset of a Charcot spinal arthropathy at a level lacking surgical arthrodesis in a paraplegic patient with traumatic cord injury.
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.
authors.affiliation: Division of Spinal Surgery, Department of Orthopaedics and Traumatology, Catholic University Hospital, Largo A Gemelli 8, 00168 Rome, Italy. proiettil@yahoo.it
authors.forename: Luca
authors.initials: L
authors.lastname: Proietti
authors.forename: Enrico
authors.initials: E
authors.lastname: Pola
authors.forename: Luigi A
authors.initials: LA
authors.lastname: Nasto
authors.forename: Laura
authors.initials: L
authors.lastname: Scaramuzzo
authors.forename: Carlo A
authors.initials: CA
authors.lastname: Logroscino
mesh_terms: D000328:Adult; D001177:Arthropathy, Neurogenic / Q000209:etiology* / Q000503:physiopathology; D004868:Equipment Failure; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects*; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D011859:Radiography; D012086:Reoperation; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013904:Thoracic Vertebrae / Q000293:injuries / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000294:innervation / Q000503:physiopathology