Charcot arthropathy of the spine in spinal cord injured individuals with sacral deafferentation and anterior root stimulator implantation
Autor: | Jörg Krebs, Dennis Grasmücke, Tobias Pötzel, Jürgen Pannek |
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Rok vydání: | 2014 |
Předmět: |
medicine.medical_specialty
Urology Urinary system medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Arthropathy medicine skin and connective tissue diseases Spinal cord injury 030203 arthritis & rheumatology Rehabilitation business.industry Medical record fungi Odds ratio Spinal cord medicine.disease Surgery body regions medicine.anatomical_structure Anesthesia Neurology (clinical) Complication business 030217 neurology & neurosurgery |
Zdroj: | Neurourology and Urodynamics. 35:241-245 |
ISSN: | 0733-2467 |
Popis: | Aims To investigate the occurrence of Charcot spinal arthropathy (CSA) after sacral deafferentation (SDAF) and sacral anterior root stimulation (SARS) of the bladder in patients suffering from neurogenic lower urinary tract dysfunction (NLUTD) as a result of spinal cord injury (SCI). Methods Retrospective evaluation of patients who had undergone SDAF/SARS at a single SCI rehabilitation centre. The occurrence rate of stimulation dysfunction was determined, and the medical records and radiological images of the included patients were examined for CSA. The diagnosis of CSA was based on radiological criteria. The occurrence rate of CSA was estimated for all SARS patients and for those with SARS dysfunction, and the odds ratios (OR) for the occurrence of CSA were calculated. Results In 11/130 SARS patients (8%), CSA was observed a median 8 years (95% CI 5–16 years) after SDAF/SARS or a median 21 years (95% CI 9–41 years) after SCI had occurred. The median follow-up time was 14 years (range 6–25 years). The proportion of patients with CSA was significantly (P = 0.036) greater in patients with SARS dysfunction (7/41) than in patients without SARS dysfunction (4/89). The odds of CSA were four times greater (OR 4.3, 95% CI 1.0–21.5) in patients with SARS dysfunction compared to those without. Furthermore, the odds of CSA were 20 times greater (OR 20.2, 95% CI 8.4–47.0) in patients with SARS compared to those without. Conclusions Charcot spinal arthropathy should be considered a potential long-term complication of SDAF/SARS, and spinal instability is a possible reason for SARS dysfunction. Neurourol. Urodynam. © 2014 Wiley Periodicals, Inc. |
Databáze: | OpenAIRE |
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