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Related Concept Videos

Vertebral Column: Regions and Curvature01:16

Vertebral Column: Regions and Curvature

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The vertebral column or spine is a flexible column that supports the head, neck, and body and  allows for their movements. It also protects the spinal cord.
Regions of the Vertebral Column
In an adult, the spine is subdivided into five regions: the cervical, the thoracic, the lumbar, the sacral, and the coccygeal region. The spine initially develops as a series of 33 vertebrae; after 20 years of age, the nine bones in the sacral region, five sacral, and four coccygeal bones fuse to form...
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Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
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Do all Charcot Spine require surgery?

S Moreau1, G Lonjon1, R Jameson1

  • 1Hospital Raymond-Poincaré, Orthopedic Surgery Department, 104, boulevard Raymond-Poincaré, 92380 Garches, France.

Orthopaedics & Traumatology, Surgery & Research : OTSR
|September 27, 2014
PubMed
Summary
This summary is machine-generated.

Spinal neuroarthropathy (SNA) is a rare condition. While surgery can yield good radiographic results, conservative treatment may be a viable option, potentially preserving patient autonomy and function.

Keywords:
Axial neuroarthropathyCharcot spineConservative treatmentNeuroarthropathySpinal neuroarthropathy

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Area of Science:

  • Spine Surgery
  • Neurology
  • Rheumatology

Background:

  • Spinal neuroarthropathy (SNA), or Charcot spine, is an uncommon condition with an unclear cause.
  • Historically linked to Tabes dorsalis (syphilitic myelopathy), spinal cord lesions are now the most frequent etiology.
  • The average delay between neurological disease onset and SNA diagnosis is 18 years.

Purpose of the Study:

  • To report clinical and radiographic outcomes in 12 patients diagnosed with spinal neuroarthropathy (SNA).
  • To evaluate the efficacy of conservative versus surgical management for SNA.

Main Methods:

  • A cohort of 12 wheelchair-using patients with SNA was retrospectively reviewed.
  • Initial treatment was conservative for all patients.
  • Surgical intervention (circumferential arthrodesis) was reserved for persistent symptomatic, unstable, or infected cases.

Main Results:

  • Five patients underwent surgery, while seven were managed conservatively over a median follow-up of 4 years.
  • Two patients were not candidates for surgery due to severe back pain with progressive destruction, hip ankylosis, or an evolving bedsore.
  • One patient experienced a complete regression of back pain with conservative management.

Conclusions:

  • Current surgical recommendations favor extensive, circumferential fusion to prevent relapses, reporting good radiographic outcomes.
  • Functional results of surgical SNA treatment remain unstudied.
  • The natural evolution of SNA may be less disabling than surgery, with pathological mobility potentially aiding patient autonomy; conservative therapy is a valid consideration.