Minimally Invasive Thoracic-Lumbar Stabilization Surgery for Infected Charcot Spine Arthropathy (ICSA) After Spinal Cord Injury

Cureus, 2024 · DOI: 10.7759/cureus.55039 · Published: February 27, 2024

Simple Explanation

Charcot spinal arthropathy (CSA) is a rare condition causing spine destruction and deformity due to impaired sensation. This paper reports a case of infected Charcot spine arthropathy (ICSA) treated with minimally invasive surgery (MIS). A 49-year-old man with a spinal cord injury (SCI) developed a destructive lesion and fistula. Minimally invasive spinal reconstruction surgery, including a penetrating endplate screw, lateral lumbar interbody fusion (LLIF), and a computer-assisted rod bending system, was performed. The patient showed bony fusion six months post-surgery. The authors suggest minimally invasive reconstructive surgery can achieve good clinical results, even though ICSA treatment often requires highly invasive approaches.

Study Duration

Not specified

Participants

A 49-year-old man with spinal cord injury

Evidence Level

Case Report

Key Findings

1
Minimally invasive surgery (MIS) using LLIF and PPS resulted in controlling the inflammation in ICSA patients with spinal cord injuries.
2
The combination of various MIS techniques provides a strong spinal fusion force and is an option for the treatment of ICSA.
3
The patient's local kyphosis angle at T11 to L5 improved from 75° (pre-op) to 19° (post-op).

Research Summary

The study presents a case of ICSA in a 49-year-old man with SCI, successfully treated with minimally invasive surgery. The approach involved spinal reconstruction using penetrating endplate screws, LLIF, and a computer-assisted rod bending system. Post-surgery, the patient exhibited bony fusion at six months, with improvements in fever, back pain, appetite, and kyphosis angle. The authors suggest that MIS techniques can be a viable option for ICSA treatment, offering a less invasive alternative to traditional methods. The authors conclude that local spinal stabilization is necessary for ICSA with persistent inflammation and that the MIS techniques employed offer a strong spinal fusion force.

Practical Implications

Less Invasive Treatment Option

MIS techniques can be considered as a less invasive alternative to highly invasive surgeries for ICSA.

Improved Patient Outcomes

MIS techniques can lead to symptomatic improvement, controlling inflammation, and strong spinal fusion force.

Consideration of MIS Techniques

Spinal surgeons should consider the combination of LLIF and PPS using techniques like penetrating endplate screws and computer-assisted rod bending for ICSA cases.

Study Limitations

1
Single case report limits generalizability.
2
The long-term outcomes of MIS for ICSA are not yet known.
3
Further research is needed to validate the effectiveness of MIS for ICSA in a larger patient population.

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