From the Department of Surgery, McMaster University, Hamilton, ON (Farrugia, Bednar, and Oitment), and the Division of Orthopedic Surgery, McMaster University, c/o St. Joseph's Hospital (Farrugia, Bednar, and Oitment).
J Am Acad Orthop Surg. 2022 Nov 1;30(21):e1358-e1365. doi: 10.5435/JAAOS-D-22-00212. Epub 2022 Aug 25.
Charcot arthropathy of the spine (CSA), also known as spinal neuroarthropathy, is a progressive disease process in which the biomechanical elements of stability of the spine are compromised because of the loss of neuroprotection leading to joint destruction, deformity, and pain. Initially thought to be associated with infectious causes such as syphilis; however in the latter part of the century, Charcot arthropathy of the spine has become associated with traumatic spinal cord injury. Clinical diagnosis is challenging because of the delayed presentation of symptoms and concurrent differential diagnosis. Although radiological features can assist with diagnosis, the need for recognition and associated treatment is vital to limit the lifelong disability with the disease. The goals of treatment are to limit symptoms and provide spinal stabilization. Surgical treatment of these patients can be demanding, and alternative techniques of instrumentation are often required.
脊柱夏科氏关节病(CSA),又称脊髓神经关节病,是一种进行性疾病过程,由于失去神经保护导致关节破坏、畸形和疼痛,脊柱的生物力学稳定性要素受到损害。最初被认为与梅毒等感染性病因有关;然而,在本世纪后期,脊柱夏科氏关节病与外伤性脊髓损伤相关联。由于症状出现延迟和并发的鉴别诊断,临床诊断具有挑战性。虽然影像学特征有助于诊断,但认识到该病并进行相关治疗对于限制其终身残疾至关重要。治疗的目标是限制症状并提供脊柱稳定。这些患者的手术治疗可能具有挑战性,通常需要替代的器械技术。