Surgical Management Of Charcot Spinal Arthropathy: A Systematic Review

Introduction: Charcot spinal arthropathy (CSA) is a rare condition characterized by destructive bone and joint changes in the spine due to loss of neurological input. Circumferential arthrodesis has proven to be definitive surgical treatment in addressing CSA and related central nervous system complications.
We aim to determine the incidence, presentation and management of Spinal Charcot Spinal arthropathy.

Methods: Using PRISMA guidelines, the authors performed a search of the PubMed/MEDLINE, Embase/Ovid, and Cochrane Central databases to identify all full-text articles with the following inclusion criteria: 1) Charcot spinal arthropathy; 2) case reports; 3) case series; 4) surgical and non-surgical treatment indication for Charcot spinal arthropathy. Studies that were not published in the English language, poster presentations, review articles, literature review, systematic review, meta-analyses, letters to the editor, and meeting abstracts were excluded.

Results: Our systematic review came up with ninety-nine articles consisting of 248 patients. Among patients with reported symptoms (97.18%, n=242), low back pain was the primary complaint in 56.43% (136) of cases. Of the 82.47% (209) patients that underwent surgical treatment, 39.23% (n=82) underwent PSF and 45.45% (n=95) of patients underwent circumferential arthrodesis.

Conclusion : Circumferential arthrodesis and posterior instrumentation and fusion are commonly performed procedures in patients with CSA. They promote long-term spinal stability and consequently, improved quality of life in these patients.