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外伤性脊髓损伤截瘫患者,在未行手术关节融合的部位发生夏科氏脊髓关节病。

Onset of a Charcot spinal arthropathy at a level lacking surgical arthrodesis in a paraplegic patient with traumatic cord injury.

机构信息

Division of Spinal Surgery, Department of Orthopaedics and Traumatology, Catholic University Hospital, Largo A Gemelli 8, 00168 Rome, Italy.

出版信息

Eur Spine J. 2010 Jul;19 Suppl 2(Suppl 2):S83-6. doi: 10.1007/s00586-009-1055-0. Epub 2009 Jun 7.

Abstract

The study design included a case report of Charcot spinal arthropathy treated with posterior and anterior spinal instrumentation. The objective of the study was to report an unusual case of Charcot spinal arthropathy as a late complication of traumatic spinal cord injury in a patient previously treated with a long posterior thoraco-lumbar instrumentation and postero-lateral fusion. A 33-year-old man with T10-T11 complete paraplegia presented with focal low back pain, kyphotic deformity of the lumbar region with L2-L3 fracture-dislocation and hardware failure. Our treatment consisted of a circumferential arthrodesis performed with a combined anterior and posterior approach. Spinal stabilization was achieved and the patient was pain free and able to resume a sitting posture. This report suggests that the development of a Charcot spine arthropathy must always be considered as a late complication of a spinal cord injury. Moreover, we would emphasize the fundamental role of a strict clinical and radiological follow-up in order to detect an early Charcot spine complication.

摘要

本研究设计包括一例采用后路和前路脊柱器械治疗夏科氏脊髓关节病的病例报告。本研究的目的是报告一例罕见的夏科氏脊髓关节病病例,该病例为先前接受长后路胸腰椎器械和后外侧融合治疗的创伤性脊髓损伤的晚期并发症。一名 33 岁男性,T10-T11 完全截瘫,出现局部腰痛、腰椎后凸畸形伴 L2-L3 骨折脱位和内固定失败。我们的治疗包括采用前路和后路联合入路进行的全环关节融合术。脊柱得到稳定,患者疼痛消失并能够恢复坐姿。本报告提示,夏科氏脊髓关节病的发生必须始终被视为脊髓损伤的晚期并发症。此外,我们强调严格的临床和影像学随访的重要性,以便早期发现夏科氏脊髓并发症。

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本文引用的文献

1
Charcot spinal disease after spinal cord injury.脊髓损伤后夏科氏脊柱病
J Neurosurg Spine. 2008 Nov;9(5):419-26. doi: 10.3171/SPI.2008.9.11.419.
3
Charcot's disease of the spine: diagnosis and treatment.脊柱夏科氏病:诊断与治疗
Spine (Phila Pa 1976). 2005 Jun 1;30(11):E315-22. doi: 10.1097/01.brs.0000164283.01454.9f.
4
Post-traumatic spinal deformity.创伤后脊柱畸形
Spine (Phila Pa 1976). 2001 Dec 15;26(24 Suppl):S111-8. doi: 10.1097/00007632-200112151-00019.
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Surgical treatment of neuropathic spinal arthropathy.
J Spinal Disord. 1991 Sep;4(3):319-28. doi: 10.1097/00002517-199109000-00009.

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