後頭下減圧術後に関節窩の骨リモデリングを生じた Charcot 肩の一例

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  • Remodeling the shoulder joint after suboccipital decompression for Charcot shoulder with syringomyelia:<BR>A case study

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Charcot shoulder is often caused by syringomyelia in the cervical spine. Currently, there is no effective treatment available for this condition. We report a case of Charcot shoulder that showed improvement in elevation after we performed suboccipital decompression for syringomyelia associated with adult-onset Chiari malformation type I.<BR>A 55-year-old woman who was diagnosed with syringomyelia associated with Chiari malformation type I had been experiencing numbness in the left hand since the age of 22. On examination, C5-T1-innervated muscle weakness, atypical sensory loss, and sweating disorder on the left side of the body was found. She first experienced difficulty in elevating her left shoulder at the age of 42. A radiograph and CT imaging revealed destruction of the humeral head and glenoid. MRI showed marked hydrarthrosis. She was diagnosed with Charcot shoulder at the age of 49. She underwent surgery at the age of 50 because the weakness in her upper limbs was progressing, the flexion range of her left shoulder was limited to 50°, and shoulder abduction was 50° owing to instability. Postoperatively, her upper limb regained muscle strength, the numbness disappeared and the sensory disturbances improved. The shoulder-joint function improved gradually. Further, she was able to abduct her shoulder by 160 °, and her shoulder stability improved by the time she was 54 years old. Using CT, small bone fragments were fused together to form a new articular surface. It was suggested that bone remodeling occurred because of neural recovery.

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  • 肩関節

    肩関節 37 (2), 893-896, 2013

    日本肩関節学会

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