Oda Yoshiaki, Uotani Koji, Tetsunaga Tomoko, Shinohara Kensuke, Ozaki Toshifumi
Department of Orthopedic Surgery, Okayama University Hospital, Okayama, JPN.
Department of Musculoskeletal Traumatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, JPN.
Cureus. 2025 Mar 16;17(3):e80656. doi: 10.7759/cureus.80656. eCollection 2025 Mar.
Charcot spinal arthropathy, a rare refractory progressive disease, is characterized by symptoms such as pain, deformity, and neurological impairment, which can significantly reduce functional ability, quality of life, and life expectancy. We report a case of Charcot spine at the L5/S1 level with long segment ankylosis to the L5 vertebra. We first performed thorough debridement via a posterior approach. We used antibiotic-containing cement as a spacer to fill the dead space, facilitating the second surgery approach. In the second surgery, transdiscal screws, which have a low profile and strong force, were used as anchors, and bulk bone harvested from both iliac bones was grafted to the intervertebral space. The lumbosacral alignment was kyphotic, and the patient could sit and move independently. Disimpaction was impossible, and a stoma had to be created.
夏科氏脊柱关节病是一种罕见的难治性进行性疾病，其特征为疼痛、畸形和神经功能障碍等症状，这些症状会显著降低功能能力、生活质量和预期寿命。我们报告一例L5/S1水平的夏科氏脊柱病病例，其长节段融合至L5椎体。我们首先通过后路进行了彻底清创。我们使用含抗生素的骨水泥作为间隔物填充死腔，为二次手术入路提供便利。在二次手术中，使用外形低矮且力量强大的经椎间盘螺钉作为锚定物，并将取自双侧髂骨的大块骨移植到椎间隙。腰骶部呈后凸畸形，患者能够独立坐立和活动。无法进行减压，必须造瘘。
