Problem of dealing with a Charcot spinal arthropathy with a novel hybrid fibular autograft and expandable cage.
J Neurosurg Backbone. 2018 Apr 13;:1-6
Authors: Ohana N, Benharroch D, Sheinis D
A 26-year-old man, who was paraplegic for six years as a consequence of a motorized vehicle accident, offered to the authors’ clinic following his incapacity to face up to a sitting posture, the frequent sensation of “clicks” in his again, and a criticism of again ache whereas in his wheelchair. On imaging, his dorsal backbone confirmed an entire arthrodesis of the primarily fused vertebrae. Nevertheless, distal to this section, a Charcot spinal arthropathy with subluxation of T12-L1 was evident. Restore of this complicated, unusual, late complication of his paraplegia by the incessantly used fusion methods was proven to be inappropriate. A novel and elaborate surgical process is offered by which an entire fusion of the affected backbone was secured. A left retrodiaphragmatic strategy was used. Full corpectomy of each the T-12 and L-1 vertebrae to the preserved endplates was carried out. A lot of the affected person’s fibula was resected and formed for engrafting. The section of the fibula was launched right into a mesh cage, earlier than its intramedullary implantation into the T-12 and L-1 vertebrae. This 2-step process mixed the hybrid use of a fibular autograft and an expandable mesh cage, included one into the opposite, in an progressive intramedullary place. This intervention allowed the affected person to renew his former situation as an especially bodily energetic affected person with paraplegia. 9 years later, an asymptomatic early-stage Charcot backbone was discovered at L5-S1, however no therapy is deliberate at this level.
PMID: 29652238 [PubMed – as supplied by publisher]