Neuropathic Spinal Arthropathy -Charcot Spine
This is the progressive erosion of disk space leading to the destruction of the disk and of the adjacent vertebral endplates, to the extent that it can cause the complete disappearance of said structure, which tends to provoke severe instability and/or vertebral deformity. It occurs in patients with spinal injury, and always at levels distal to the neurological injury.
WHY DOES IT OCCUR?
There is always a substrate of underlying neurological injury that affects the proprioception of the area and which changes the physiological mechanisms of biological repair of local damage. Historically, it was associated to luetic neuropathies; currently DM is the most prevalent. In our specific context of spinal injury we see it quite frequently, always at a vertebral level distal to the baseline neurological injury.
It may occur spontaneously, but tends to be triggered by local damage (trauma, surgery, etc.) or by prolonged mechanical stress (hinge areas, levels immediately distal to instrumentation, etc.).