{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,4,16]],"date-time":"2023-04-16T04:10:59Z","timestamp":1681618259451},"reference-count":14,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:p>A 26-year-old man, who was paraplegic for 6 years due to a motor vehicle accident, presented to the authors\u2019 clinic following his incapacity to withstand a sitting posture, the frequent sensation of \u201cclicks\u201d in his back, and a complaint of back pain while in his wheelchair. On imaging, his dorsal spine showed a complete arthrodesis of the primarily fused vertebrae. However, distal to this segment, a Charcot spinal arthropathy with subluxation of T12\u2013L1 was evident. Repair of this complex, uncommon, late complication of his paraplegia by the frequently used fusion techniques was shown to be inappropriate. A novel and elaborate surgical procedure is presented by which a complete fusion of the affected spine was secured. A left retrodiaphragmatic approach was used. Complete corpectomy of both the T-12 and L-1 vertebrae to the preserved endplates was performed. Most of the patient\u2019s fibula was resected and shaped for engrafting. The segment of the fibula was introduced into a mesh cage, before its intramedullary implantation into the T-12 and L-1 vertebrae. This 2-step procedure combined the hybrid use of a fibular autograft and an expandable mesh cage, incorporated one into the other, in an innovative intramedullary position. This intervention allowed the patient to resume his former condition as an extremely physically active patient with paraplegia. Nine years later, an asymptomatic early-stage Charcot spine was found at L5\u2013S1, but no treatment is planned at this point.<\/jats:p>","DOI":"10.3171\/2017.10.spine17606","type":"journal-article","created":{"date-parts":[[2018,4,13]],"date-time":"2018-04-13T14:02:19Z","timestamp":1523628139000},"page":"34-39","source":"Crossref","is-referenced-by-count":1,"title":["Challenge of handling a Charcot spinal arthropathy with a novel hybrid fibular autograft and expandable cage"],"prefix":"10.3171","volume":"29","author":[{"given":"Nissim","family":"Ohana","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Benharroch","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Soroka University Medical Center and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitri","family":"Sheinis","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"884","DOI":"10.1016\/j.spinee.2013.07.441","article-title":"Characteristics and surgical management of neuropathic (Charcot) spinal arthropathy after spinal cord injury","volume":"14","author":"Aebli N","year":"2014","unstructured":"Aebli N, P\u00f6tzel T, Krebs J: Characteristics and surgical management of neuropathic (Charcot) spinal arthropathy after spinal cord injury. 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