Neuropathic Spinal Arthropathy A Review of the Charcot Spine

Charcot Spinal Arthropathy in a Paraplegic Weight Lifter

“…In recent times, the condition has been seen more commonly as the result of traumatic spinal injuries, spinal tumors, syringomyelia, or secondary to diabetes. [1][2][3] However, any disease process that destroys the deep sensation to a joint, leading to continued activity despite injury or inflammation within the joint, is capable of producing Charcot arthropathy. [1][2][3][4] The majority of reports in the literature concerning Charcot arthropathy in the long-standing paraplegic patient cite previous spinal surgery and, in particular laminectomy, as important contributory factors.…”

“…[1][2][3] However, any disease process that destroys the deep sensation to a joint, leading to continued activity despite injury or inflammation within the joint, is capable of producing Charcot arthropathy. [1][2][3][4] The majority of reports in the literature concerning Charcot arthropathy in the long-standing paraplegic patient cite previous spinal surgery and, in particular laminectomy, as important contributory factors. 1,4 -6 McBride and Greenberg 5 hypothesized that the development of Charcot arthropathy in their patients, each of whom underwent posterior spinal fusion and instrumentation for the initial injury, was facilitated by an adverse biomechanical environment created by the initial fusion.…”

Increased Spasticity From a Fracture in the Baclofen Catheter Caused by Charcot Spine: Case Report

“…1,15,17 In this case, the patient had longstanding spasticity, which had been adequately treated and controlled for many years but had a sudden return and marked worsening of spastic symptoms prompting an investigation. On further imaging workup, it was determined that the patient had a longstanding degenerative and destructive process, consistent with Charcot spinal arthropathy, which led to catheter transection and baclofen pump malfunction.…”

“…3,4,15 The pathogenesis of a Charcot joint is destruction of the afferent proprioceptive nerves of the involved joint, thus rendering the joint unable to compensate for repetitive injury or minor trauma. [1][2][3]15,16 To our knowledge, this is the only reported case of increased spasticity associated with baclofen pump malfunction secondary to catheter and partial spinal cord transection that resulted from a Charcot spinal level.…”

Management of degenerative changes and stenosis of the lumbar spinal canal secondary to cervical spinal cord injury

“…Spinal Charcot joints are more easily detected, and they are well known as 'neuropathic spinal arthropathy'. [6][7][8][9][10] Pathophysiologically, we understand this entity as the organism's occasional failure in its usual response to the segment's mechanical overload by immobilizing bony apposition, which leads to pathologic hypermobility and, eventually, to segmental destruction. Its occurrence in paraplegics is another hint of the frequency of degenerative lumbar disorders in these patients.…”