NEUROTROPHIC ARTHROPATHY CAUSED BY SPINAL DISORDERS

Abstract

Neurotrophic arthropathy, also called Charcot joint, is caused by various diseases. We came across five cases associated with spinal disorders: two presented with syringomyelia with Chiari malformation, one presented with syringomyelia with arachnoiditis secondary to tuberculous meningitis, one presented with ossification of the posterior longitudinal ligament (OPLL) of the lumber spine, and one presented with spinal dysraphism. Neutrophic joints included two knees, two shoulders and one elbow. All spinal disorders were treated surgically but the Charcot joints were treated with arthrodesis in two knee cases and one shoulder case. Solid fusions of arthrodeses were completely achieved using intramedullary nailing to the knee joints and vascularized fibula graft to the shoulder joint. Pathological joints of the shoulder and elbow that did not undergo joint surgery could not be controlled by spinal surgery. Early diagnosis was important for prevention of trauma or sprains to the weight-bearing joints. MRI of the Charcot joint proved useful in confirming the pathological changes in the early destructive stage, and in determining the extent of surgical removal of it for arthrodesis.