Surgical management of a complex case of Charcot arthropathy of the spine: a case report

Spinal Cord Ser Cases. 2019 Aug 22:5:73. doi: 10.1038/s41394-019-0217-5. eCollection 2019.

Abstract

Introduction: The authors present a case of a 55-year-old male with T10 complete paraplegia diagnosed with Charcot arthropathy of the spine (CAS).

Case presentation: He presented to an outside institution with vomiting and productive cough with subsequent computed tomography (CT) and MRI imaging revealing L5 osteomyelitis and a paraspinal abscess. Given the patient's inability to remain in good posture in his wheelchair he underwent a multilevel vertebrectomy and thoracolumbar fusion. Due to multiple co-morbidities, surgical recovery was complex, ultimately requiring revision circumferential fixation.

Discussion: CAS is an uncommon, long-term complication of traumatic spinal cord injury (SCI). Surgical management is often complex and associated with significant complications. Currently, a consensus on CAS prevention, specific surgical fixation techniques and post-surgical nursing care management is lacking. In this case report we provide our experience in the management of a complex case of CAS to aid in decision making for future neurosurgeons who encounter this sequela of traumatic SCI.

Keywords: Diseases of the nervous system; Pathogenesis; Spinal cord diseases.

Publication types

  • Case Reports

MeSH terms

  • Arthropathy, Neurogenic / etiology
  • Arthropathy, Neurogenic / surgery*
  • Humans
  • Male
  • Middle Aged
  • Paraplegia / etiology
  • Spinal Cord Injuries / complications*
  • Spinal Fusion / methods
  • Spondylarthropathies / etiology
  • Spondylarthropathies / surgery*