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European Spine Journal
Published in: European Spine Journal 6/2014

01-10-2014 | Original Article

Sitting imbalance cause and consequence of post-traumatic Charcot spine in paraplegic patients

Authors: Federico De Iure, Mohammadreza Chehrassan, Michele Cappuccio, Luca Amendola

Published in: European Spine Journal | Special Issue 6/2014

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Abstract

Purpose

To analyze the role of spine alignment in post-traumatic paraplegic patient as a potential cause of late Charcot spine disease (CSD).

Method

A retrospective review of three cases in which the disease appeared more than 15 years after a spinal cord injury treated by posterior fusion. A review of the literature concerning spine balance in sitting position, especially referred to paraplegic patients, is done to validate this hypothesis.

Results

Lumbar kyphosis in paraplegic patients during the sitting position may increase the mechanical load on disks and ligament below the previously fused area. This phenomenon, in combination with lack of protective mechanism because of poor muscular support and lack of sensitivity can speed up and amplify the normal degenerative changes in the disk and ligaments.

Conclusions

More investigations are required to fully understand all the mechanisms underlying CSD pathogenesis to prevent it. Until then, a systematic long-term clinical and radiological follow-up in all post-trauma paraplegic patients is suggested. Combined anterior and posterior fusion, when feasible, can restore the sagittal balance providing a better quality of life in these patients.
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Metadata
Title
Sitting imbalance cause and consequence of post-traumatic Charcot spine in paraplegic patients
Authors
Federico De Iure
Mohammadreza Chehrassan
Michele Cappuccio
Luca Amendola
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue Special Issue 6/2014
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-014-3550-1

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