Neuropathic lumbar spondylolisthesis--a rare trigger for posture induced autonomic dysreflexia.

STUDY

DESIGN

Case report.

OBJECTIVES

Description of a rare trigger for autonomic dysreflexia.

SETTING

Princess Royal Spinal Injuries Unit, Sheffield.

METHODS AND

RESULTS

A case of Charcot's spine (neuropathic spinal arthropathy) in a woman with a traumatic T5 paraplegia is described. She developed symptoms of autonomic dysreflexia, brought on by changes in posture. The postural variation was attributable to a freely mobile neuropathic spondylolisthesis at the L4/5 level. A laminectomy performed for the implantation of a sacral anterior root stimulator was identified as a causative factor in the development of the neuropathic joint. Surgical stabilisation and fusion resulted in amelioration of her symptoms.

CONCLUSION

Neuropathic spine is a rare cause of autonomic dysreflexia that should be considered when other more common factors have been excluded. The development of Charcot's spine in the spinal cord injured population is facilitated by surgical procedures involving the vertebrae.