STUDY DESIGN: A case report of aggressive multilevel Charcot spinal arthropathy treated with staged spinal instrumentation. OBJECTIVES: To report an unusual case of Charcot spinal arthropathy, given the rapidity of progression and extent of tissue destruction, and present the results of successful spinal instrumentation and stabilization. SUMMARY OF BACKGROUND DATA: Charcot spinal arthropathy in the long-standing paraplegic patient is more commonly seen in those who have undergone prior spinal surgery and is usually restricted to 2 spinal levels. METHODS: A 36-year-old amateur weight lifter with T6 complete paraplegia presented with lower thoracic back pain, a kyphotic deformity of the thoracolumbar region, and gross spinal instability on transferring. Imaging revealed extensive bony destruction from T10-T12 and complete absence of spinal tissue over the affected levels. Staged anterior and posterior spinal instrumentation from T3 to L4 was performed. RESULTS: Spinal stabilization was achieved, and the patient was pain free and able to resume light training at 6-month follow-up. CONCLUSIONS: We would advise a high index of suspicion of Charcot arthropathy in the active paraplegic patient presenting with back pain caudal to their sensory level. Staged spinal instrumentation is an effective treatment for multilevel Charcot spinal arthropathy.
STUDY DESIGN: A case report of aggressive multilevel Charcot spinal arthropathy treated with staged spinal instrumentation. OBJECTIVES: To report an unusual case of Charcot spinal arthropathy, given the rapidity of progression and extent of tissue destruction, and present the results of successful spinal instrumentation and stabilization. SUMMARY OF BACKGROUND DATA: Charcot spinal arthropathy in the long-standing paraplegic patient is more commonly seen in those who have undergone prior spinal surgery and is usually restricted to 2 spinal levels. METHODS: A 36-year-old amateur weight lifter with T6 complete paraplegia presented with lower thoracic back pain, a kyphotic deformity of the thoracolumbar region, and gross spinal instability on transferring. Imaging revealed extensive bony destruction from T10-T12 and complete absence of spinal tissue over the affected levels. Staged anterior and posterior spinal instrumentation from T3 to L4 was performed. RESULTS: Spinal stabilization was achieved, and the patient was pain free and able to resume light training at 6-month follow-up. CONCLUSIONS: We would advise a high index of suspicion of Charcot arthropathy in the active paraplegic patient presenting with back pain caudal to their sensory level. Staged spinal instrumentation is an effective treatment for multilevel Charcot spinal arthropathy.