Charcot spinal arthropathy presenting as adjacent segment disease after lumbar spinal fusion surgery in Parkinson's disease: A case report

被引:2
作者
Miura, Kousei [1 ,2 ]
Koda, Masao [1 ]
Tatsumura, Masaki [3 ]
Shiina, Itsuo [4 ]
Mammoto, Takeo [3 ]
Hirano, Atsushi [3 ]
Abe, Tetsuya [1 ]
Funayama, Toru [1 ]
Noguchi, Hiroshi [1 ]
Yamazaki, Masashi [1 ]
机构
[1] Univ Tsukuba, Dept Orthopaed Surg, Fac Med, 1-1-1 Tennodai, Tsukuba, Ibaraki 3058575, Japan
[2] Univ Tsukuba Hosp, Dept Rehabil Med, Fac Med, 1-1-1 Tennodai, Tsukuba, Ibaraki 3058575, Japan
[3] Tsukuba Univ Hosp, Mito Clin Educ & Training Ctr, Dept Orthopaed Surg & Sports Med, 3-2-7 Miya Machi, Mito, Ibaraki 3100015, Japan
[4] Moriya Daiichi Gen Hosp, Dept Orthopaed Surg, 1-17 Matsumaedai, Ibaraki 3020102, Japan
关键词
Charcot spinal arthropathy; Neuroarthropathic change; Parkinson's disease; Adjacent segment disease; SURGICAL-TREATMENT;
D O I
10.1016/j.jocn.2018.11.013
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Charcot spinal arthropathy (CSA) is a rare spinal disorder presenting neuropathic osteoarthropathy of facet joints leading to progressive destruction. After L4-5 PLIF, a 63-year-old woman with Parkinson's disease (PD) underwent L3-4 and L5-S1 PLIF for primary adjacent segment disease caused by degenerative change, which was found as facet joint osteophytes and a vacuum disc phenomenon with endplate sclerosis. However, her postural disorder from PD deteriorated, and strong opioid analgesics were administered for severe recurring low back pain. Anterior subluxation at L2-3 occurred because of destructive secondary adjacent segment disease, which was found as destruction of the endplate and the facet without degenerative change, and formation of paravertebral osteophytes and fluid collection in the intervertebral space. The appearance on imaging met that for neuroarthropathic change, which was previously reported as CSA. L2-3 PLIF following extension of posterior fusion to T10 was additionally performed, and the postoperative course was uneventful with symptomatic improvement. In this case, the important finding was in the different appearance of the disease between adjacent segments on imaging. It is possible that deterioration of PD and administration of the analgesics inhibited deep pain sensation, and concentration of mechanical stress in the proximal adjacent segment by the long lever arm because of extension of the fusion level resulted in neuroarthropathic change of the facets in the secondary adjacent segments. The pathophysiology of association of CSA and PD remains unknown. However, we recommend vigilance for destructive neuroarthropathic facet change as CSA after spinal surgery in patients with severe PD. (C) 2018 Elsevier Ltd. All rights reserved.
引用
收藏
页码:281 / 284
页数:4
相关论文
共 13 条
  • [1] ARNOLD PM, 1995, J SPINAL DISORD, V8, P357
  • [2] Barrey C., 2010, Annals of Physical and Rehabilitation Medicine, V53, P200, DOI 10.1016/j.rehab.2009.11.008
  • [3] Postural disorders in Parkinson's disease
    Benatru, I.
    Vaugoyeau, M.
    Azulay, J. -P.
    [J]. NEUROPHYSIOLOGIE CLINIQUE-CLINICAL NEUROPHYSIOLOGY, 2008, 38 (06): : 459 - 465
  • [4] NEUROPATHIC (CHARCOT) ARTHROPATHY OF THE SPINE AFTER TRAUMATIC SPINAL PARAPLEGIA
    BROWN, CW
    JONES, B
    DONALDSON, DH
    AKMAKJIAN, J
    BRUGMAN, JL
    [J]. SPINE, 1992, 17 (06) : S103 - S108
  • [5] SURGICAL-TREATMENT OF NEUROPATHIC SPINAL ARTHROPATHY
    DEVLIN, VJ
    OGILVIE, JW
    TRANSFELDT, EE
    BOACHIEADJEI, O
    BRADFORD, DS
    [J]. JOURNAL OF SPINAL DISORDERS, 1991, 4 (03): : 319 - 328
  • [6] PARKINSONISM - ONSET PROGRESSION AND MORTALITY
    HOEHN, MM
    YAHR, MD
    [J]. NEUROLOGY, 1967, 17 (05) : 427 - &
  • [7] Charcot spinal arthropathy
    Lee, Dennis
    Dahdaleh, Nader S.
    [J]. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE, 2018, 9 (01) : 9 - 19
  • [8] Loriaut P, 2014, CASE REP ORTHOPEDICS, V2014, DOI [10.1155/2014/631346.631346, DOI 10.1155/2014/631346.631346]
  • [9] Charcot spinal disease after spinal cord injury
    Morita, Masahiro
    Miyauchi, Akira
    Okuda, Shinya
    Oda, Takenori
    Yamamoto, Tomio
    Iwasaki, Motoki
    [J]. JOURNAL OF NEUROSURGERY-SPINE, 2008, 9 (05) : 419 - 426
  • [10] Charcot spine as a late complication of traumatic spinal cord injury
    Standaert, C
    Cardenas, DD
    Anderson, P
    [J]. ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 1997, 78 (02): : 221 - 225