Charcot arthropathy of the lumbar spine treated using one-staged posterior three-column shortening and fusion.
METHODS
Case report.


OBJECTIVE
We present a case of lumbar Charcot arthropathy successfully treated surgically using posterior 3-column resection, spinal shortening, and fusion.


BACKGROUND
The operative treatment of Charcot arthropathy of the spine has conventionally been a combination of anterior and posterior surgery. The morbidity associated with these surgical procedures can be considerable. A posterior-only approach to the problem would avoid the additional morbidity associated with an anterior approach. We present a case of lumbar Charcot arthropathy with deformity treated successfully using such a procedure.


METHODS
Discussion of the patient's clinical and radiologic history, the technical merits of the operative intervention and a review of the relevant background literature are presented.


RESULTS
A multilevel, single-stage, posterior 3-column resection with primary shortening and instrumented fusion augmented with rhBMP2 in a multiply operated patient with deformity provided a optimal biologic and mechanical environment for healing of the Charcot arthropathy and improved the sagittal and coronal profile of the spine.


CONCLUSIONS
A single-stage, multilevel, posterior 3-column resection and primary shortening can be a useful surgical strategy in symptomatic patients with Charcot arthropathy of the spine.
David
Kenny Samuel
KS
University of Toronto, University Health Network, Toronto Western Hospital, Toronto, Canada,
Agarwala
Amit Omprakash
AO
Rampersaud
Yoga Raja
YR
D000328:Adult; D001177:Arthropathy, Neurogenic / Q000601:surgery*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome