We present a case of lumbar Charcot arthropathy successfully treated surgically using posterior 3-column resection, spinal shortening, and fusion.
The operative treatment of Charcot arthropathy of the spine has conventionally been a combination of anterior and posterior surgery. The morbidity associated with these surgical procedures can be considerable. A posterior-only approach to the problem would avoid the additional morbidity associated with an anterior approach. We present a case of lumbar Charcot arthropathy with deformity treated successfully using such a procedure.
Discussion of the patient's clinical and radiologic history, the technical merits of the operative intervention and a review of the relevant background literature are presented.
A multilevel, single-stage, posterior 3-column resection with primary shortening and instrumented fusion augmented with rhBMP2 in a multiply operated patient with deformity provided a optimal biologic and mechanical environment for healing of the Charcot arthropathy and improved the sagittal and coronal profile of the spine.
A single-stage, multilevel, posterior 3-column resection and primary shortening can be a useful surgical strategy in symptomatic patients with Charcot arthropathy of the spine.
We present a case of lumbar Charcot arthropathy successfully treated surgically using single-stage, multilevel posterior 3-column resection, spinal shortening and fusion augmented with bone morphogentic protein.
From the *University of Toronto, University Health Network, Toronto Western Hospital, Toronto, Canada; and †Panorama Orthopedics and Spine Center.
Acknowledgment date: May 14, 2009. Revision date: September 8, 2009. Acceptance date: September 11, 2009.
The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.
No funds were received in support of this work. One or more of the author(s) has/have received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this manuscript: e.g., honoraria, gifts, and consultancies.
Y. R. R. is a consultant for Medtronic Sofamor Danek.
Address correspondence and reprint requests to: Yoga Raja Rampersaud, MD, FRCSC, Krembil Neuroscience Center, Spine Program, University Health Network, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada; E-mail: firstname.lastname@example.org.