Tactics of surgical treatment of chronic osteomyelitis of the spine on the background of traumatic plegia (Charcot spinal neuropathy)
https://doi.org/10.18705/3034-7270-2025-1-4-88-99
Abstract
Charcot spinal neuroarthropathy is a rare disease that is caused by post-traumatic disorders of proprioception and deep sensitivity, and is manifested by the formation of pseudoarthrosis and instability of the spinal motor segments below the site of its damage. The aim of the study was to study the features of the clinical course and methods of surgical treatment of spondylitis on the background of Сharcot spinal neuroarthropathy. Design is a small clinical series and literature review. The study included 10 clinical observations of patients with Сharcot spinal neuroarthropathy who were treated at the St. Petersburg Research Institute of Phthisiopulmonology of the Ministry of Health of the Russian Federation from 2014 to 2024. According to the results of bacteriological and histological examinations, the patients were divided into two groups. Group A included four patients with aseptic inflammation, and group B included 6 patients with purulent inflammation verified by histological examination. In 66.7 % of cases (4 patients) populations of S. Epidermidis-1, S. aureus-1, E. coli.-1, Prot. vulgaris-1 were detected in the crops of these patients. With timely surgical treatment, most patients, especially those with incomplete paraplegia, have a good short-term prognosis, however, in the long term, 30 % of patients undergo re-surgery due to the development of instability of the vertebral-motor segment, the formation of an adjacent level syndrome and/or the progression of the inflammatory process in the spine
About the Authors
A. A. Vishnevsky
Russian Federation Healthcare Ministry Saint-Petersburg State Phthisiopulmonology Research Institute
Russian Federation
Russian Federation
Vishnevsky Arkadiy A. – Doctor of Medical Sciences, Leading Researcher, Professor
St. Petersburg
D. G. Naumov
Russian Federation Healthcare Ministry Saint-Petersburg State Phthisiopulmonology Research Institute ; Saint-Petersburg State University
Russian Federation
Russian Federation
Naumov Denis G. – Candidate of Medical Sciences, Deputy Director of Traumatology and Orthopedics
St. Petersburg
M. V. Belyakov
Russian Federation Healthcare Ministry Saint-Petersburg State Phthisiopulmonology Research Institute
Russian Federation
Russian Federation
Belyakov Mikhail V. – Candidate of Medical Sciences
St. Petersburg
I. A. Sovpenchuk
Russian Federation Healthcare Ministry Saint-Petersburg State Phthisiopulmonology Research Institute
Russian Federation
Russian Federation
Sovpenchuk Igor A. – orthopedic traumatologist
St. Petersburg
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Review
For citations:
Vishnevsky A.A., Naumov D.G., Belyakov M.V., Sovpenchuk I.A. Tactics of surgical treatment of chronic osteomyelitis of the spine on the background of traumatic plegia (Charcot spinal neuropathy). Russian surgical journal. 2025;1(4):88-99. (In Russ.) https://doi.org/10.18705/3034-7270-2025-1-4-88-99
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