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Four-rod Instrumentation for Treatment of Charcot Spinal Arthropathy Causing Autonomic Dysreflexia: Case Report and Literature Review

Late complications of spinal cord injury can include Charcot arthropathy, in which spinal instability occurs as a result of repetitive trauma in the insensate spine. In rare cases, this can present as autonomic dysreflexia. We present the case of a 60-year-old man with longstanding C6 quadriplegia w...

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Autores principales: Zyck, Stephanie, Toshkezi, Gentian, Pizzuti, John, Marawar, Satya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120971/
https://www.ncbi.nlm.nih.gov/pubmed/27909638
http://dx.doi.org/10.7759/cureus.850
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author Zyck, Stephanie
Toshkezi, Gentian
Pizzuti, John
Marawar, Satya
author_facet Zyck, Stephanie
Toshkezi, Gentian
Pizzuti, John
Marawar, Satya
author_sort Zyck, Stephanie
collection PubMed
description Late complications of spinal cord injury can include Charcot arthropathy, in which spinal instability occurs as a result of repetitive trauma in the insensate spine. In rare cases, this can present as autonomic dysreflexia. We present the case of a 60-year-old man with longstanding C6 quadriplegia who presented with six months of hypertension, diaphoresis and dizziness. After an extensive workup, the patient's symptoms were attributed to autonomic dysreflexia in the setting of spinal instability from Charcot spinal arthropathy. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed instability with degenerative changes at L1-L2. We present our case with a literature review to discuss management of this uncommon situation. The patient underwent posterior fusion and instrumentation from T8-L5 with four rods, alternating screws and crosslinks with a good reduction and solid stabilization of the spine. Postoperatively, the patient experienced immediate relief of all symptoms. Our case demonstrates effective surgical treatment for Charcot spinal arthropathy causing autonomic dysreflexia. Stabilization with instrumentation and fusion of underlying Charcot spinal arthropathy removed the trigger of the autonomic dysreflexia and alleviated our patient's symptoms.
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spelling pubmed-51209712016-12-01 Four-rod Instrumentation for Treatment of Charcot Spinal Arthropathy Causing Autonomic Dysreflexia: Case Report and Literature Review Zyck, Stephanie Toshkezi, Gentian Pizzuti, John Marawar, Satya Cureus Neurosurgery Late complications of spinal cord injury can include Charcot arthropathy, in which spinal instability occurs as a result of repetitive trauma in the insensate spine. In rare cases, this can present as autonomic dysreflexia. We present the case of a 60-year-old man with longstanding C6 quadriplegia who presented with six months of hypertension, diaphoresis and dizziness. After an extensive workup, the patient's symptoms were attributed to autonomic dysreflexia in the setting of spinal instability from Charcot spinal arthropathy. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed instability with degenerative changes at L1-L2. We present our case with a literature review to discuss management of this uncommon situation. The patient underwent posterior fusion and instrumentation from T8-L5 with four rods, alternating screws and crosslinks with a good reduction and solid stabilization of the spine. Postoperatively, the patient experienced immediate relief of all symptoms. Our case demonstrates effective surgical treatment for Charcot spinal arthropathy causing autonomic dysreflexia. Stabilization with instrumentation and fusion of underlying Charcot spinal arthropathy removed the trigger of the autonomic dysreflexia and alleviated our patient's symptoms. Cureus 2016-10-27 /pmc/articles/PMC5120971/ /pubmed/27909638 http://dx.doi.org/10.7759/cureus.850 Text en Copyright © 2016, Zyck et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurosurgery
Zyck, Stephanie
Toshkezi, Gentian
Pizzuti, John
Marawar, Satya
Four-rod Instrumentation for Treatment of Charcot Spinal Arthropathy Causing Autonomic Dysreflexia: Case Report and Literature Review
title Four-rod Instrumentation for Treatment of Charcot Spinal Arthropathy Causing Autonomic Dysreflexia: Case Report and Literature Review
title_full Four-rod Instrumentation for Treatment of Charcot Spinal Arthropathy Causing Autonomic Dysreflexia: Case Report and Literature Review
title_fullStr Four-rod Instrumentation for Treatment of Charcot Spinal Arthropathy Causing Autonomic Dysreflexia: Case Report and Literature Review
title_full_unstemmed Four-rod Instrumentation for Treatment of Charcot Spinal Arthropathy Causing Autonomic Dysreflexia: Case Report and Literature Review
title_short Four-rod Instrumentation for Treatment of Charcot Spinal Arthropathy Causing Autonomic Dysreflexia: Case Report and Literature Review
title_sort four-rod instrumentation for treatment of charcot spinal arthropathy causing autonomic dysreflexia: case report and literature review
topic Neurosurgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120971/
https://www.ncbi.nlm.nih.gov/pubmed/27909638
http://dx.doi.org/10.7759/cureus.850
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