Post-Traumatic Charcot (Neuropathic) Spinal Arthropathy at Cervicothoracic Junction: Case Report.
World Neurosurg. 2016 Jul 26;
Authors: Aydinli U, Mohan N, Kara K
Charcot spine arthropathy (post – traumatic neuroarthropathy of the spine) has been reported to be a very late and rare complication of spinal cord injury. Charcot of the cervicothoracic and upper thoracic region is rarely reported in the literature. Charcot spinal arthropathy (CSA) is a cause of progressive deformity and may present as late as 30 years after the original spinal cord injury. This is more common in paraplegic patients who are actively ambulating. A case of a fifty six years old patient with complete paraplegia for about twenty years after spinal cord injury presented with severe kyphous deformity and instability of thoracolumbar spine. His sensory level to deep pain was at thoracic (D4). He kept developing new neuroathropathies at different segments within a span of five to six months after every decompression and fusion with anterior cage and posterior instrumentation done. A total of three surgeries had been done in span of two years, initial thoracic, then lumbar and finally cervicothoracic junction. We present this case due to challenges in surgery for instrumentation of new Charcot spinal arthropathy. Reports of neuroarthropathy developing above level of spinal cord injury and at the cervicothoracic junction are rare. The treating surgeon should be cognizant of the possibility of developing secondary levels of neuroarthropathy above and below a previously successful fusion.
PMID: 27474457 [PubMed – as supplied by publisher]