Abstract
Charcot spine, also known as neuropathic spinal arthropathy and Charcot spinal arthropathy, is a rare and potentially devastating consequence of spinal cord injury. Treatment of this condition ranges from observation, immobilization with bracing or jacket, or surgical stabilization. A 52-year-old male, with a history of a C6-7 spinal cord injury over 30 years ago, presented to our hospital with complaints of worsening of his chronic low back pain over the prior 6 months. His pain was exacerbated with movement, and he also found it more difficult to sit up straight in his wheelchair. MR imaging of the spine demonstrated the large fluid collection with transection of the thecal sac and spinal cord at T10-11, along with the prior known spinal cord injury at C6-7. Given the patient’s clinical presentation and signs of progressive degenerative changes with worsening kyphosis, the patient underwent a T7- L3 posterior instrumented fusion for stabilization. Through the same incision, an extracavitary approach was utilized for placement of an expandable titanium case for anterior column support. After the operation, he experienced a significant reduction in pain and noted improved posture in his wheelchair
Highlights
According to the American Psychiatric Association (APA, 2000) the Posttraumatic Stress Disorder (PTSD) is a syndrome in which the symptoms are presumably caused by a specific traumatic event [1]
11 articles were excluded for the following reasons: one was excluded because no validated PTSD measure was used [14]; one was excluded, because the article included children from 3 years [15]; four articles were excluded because no PTSD prevalence rates were reported in the articles [10,16,17,18]; two articles concerning accident survivors, physically injured and trauma patients were excluded because the populations consisted of patients not necessarily admitted to intensive care unit (ICU) [19,20,21]; and two studies concerning septic shock/sepsis patients were excluded because not all patients were admitted to an ICU [22,23]
It is concluded that PTSD following ICU treatment is common and negatively affects the patient’s health related quality of life (HRQOL)
Summary
According to the American Psychiatric Association (APA, 2000) the PTSD is a syndrome in which the symptoms are presumably caused by a specific traumatic event [1]. The disorder is characterized by three symptom groups: 1) re-experience symptoms (flashbacks, nightmares and intrusive memories related to the traumatic event); 2) avoidance symptoms (the person is making efforts to avoid stimuli reminding of the trauma), and 3) symptoms of increased arousal (irritability, hypervigilance, diminished concentration etc.). Much research has urged to identify factors that can predict those at risk of developing PTSD following a traumatic experience. A range of risk factors have been identified across studies e.g. psychiatric history, reported childhood abuse, and family psychiatric history [3] and female gender [4]
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