Charcot spinal arthropathy: an increasing long-term sequel after spinal cord injury with no straightforward management

Abstract

Charcot spinal arthropathy (CSA) is most likely increasing in patients suffering from consequences of spinal cord injury. We want to highlight initial symptoms, certain risk factors and perioperative complications of this condition. A single center retrospective case series in a specialized Center for Spinal Cord Injuries, BG Trauma Center Murnau, Germany highlighting the potential obstacles in the management of Charcot spine. We describe four female paraplegic patients (mean age: 50.75 years; range: 42-67), who developed Charcot spinal arthropathies. The mean age at the time of the accident was 21.5 years (3-35), the time lag after the accident before CSA was developed and finally diagnosed was on average 29.5 years (17-39) and the mean follow-up period was 39.5 months (6-73). Patient histories, initial symptoms, risk factors as well as the management and postoperative complications are provided. Charcot spine is an important potential sequel of spinal cord injury, which can lead to significant disability and spinal emergencies in affected individuals. More studies are needed to provide better recommendations for spine surgeons. Conservative treatment is an option. Posterior fixation alone does not seem to be sufficient.

An examination of diurnal variations in neuropathic pain and affect, on exercise and non-exercise days, in adults with spinal cord injury

“…Published case series of individuals with SCI typically include 5-10 cases [27][28][29][30][31]. For this case series, we aimed to recruit individuals with SCI who: were greater than 1 year post injury; experienced below-level neuropathic pain; were meeting the SCI physical activity guidelines (PAG) [32]; were able to read and write English; and had access to a Smartphone.…”

Infected charcot spine arthropathy

“…Presence of an overlying skin breakdown or a fistula makes the infection apparent and may be picked up early [11,12]. An associated syrinx in case 2 may also have contributed to the relatively early presentation [14].…”

Very early Charcot spinal arthropathy associated with forward bending after spinal cord injury: a case report

“…Although most commonly associated with traumatic SCI, CSA can be caused by any condition that impairs spinal sensory feedback, including hereditary insensitivity to pain, transverse myelitis, syringohydromyelia, diabetes, and others [3]. Persons with paraplegia with recurrent infections have been reported to be at increased risk for the development of CSA [4][5][6].…”