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1265 - Spinal Cord Injury Secondary to Advanced Facet Arthropathy: A Case Report

Friday, February 28, 2025

5:00 PM - 6:30 PM MST

Presenting Author(s)

NS

Neil J. Simmons, MD

Resident Physician PGY3
University of Arkansas for Medical Sciences (UAMS)
Little Rock, Arkansas, United States

Co-Author(s)

TK

Thomas S. Kiser, MD

Attending Physician
University of Arkansas for Medical Sciences (UAMS)
Little Rock, Arkansas, United States
ZD

Zach Dawes, DO

Attending Physician
Ochsner Medical Center - Baton Rouge
Baton Rouge, Louisiana, United States
KQ

Kevin Quibodeaux, BS

Medical Student
Kansas City University College of Osteopathic Medicine
Webb City, Missouri, United States

Case Diagnosis: T8 AIS C Spinal Cord Injury

Case Description: There is little literature regarding spinal cord injuries (SCI) caused by heterotopic bone growth into the posterior spinal canal secondary to advanced facet arthropathy (FA). There are however several case reports that detail SCI secondary to spinal cord infarction with FA being indicated as a possible risk factor (specifically facet joint septic arthritis and osteophytic bony encroachment at level of infarction). Our case study follows the rehabilitation course of a 72-year-old male that was diagnosed with a T8 AIS C SCI secondary to heterotopic bone growth originating from the bilateral facet joints.

Discussions: Our patient had a one-month history of progressive numbness in the bilateral lower extremities (BLE) around the anterior shins and worsening balance. After performing a quick twisting motion that caused him to fall, he experienced sudden onset BLE weakness. Imaging revealed severe T8-T9 and T9-T10 posterior spinal canal stenosis secondary to heterotopic bone formation originating from bilateral facet joints. He underwent T7-T9 decompression laminectomy with hypertrophic bone removal and bilateral foraminotomies. He was then admitted to an acute care rehab (ACR) unit. His presentation had findings consistent with myelopathy, with leg weakness and alterations in proprioception as well as fine touch discrimination. During his stay at an ACR unit, he showed improved leg strength and bowel and bladder function. Unfortunately, due to slow progress secondary to age and the need for help at home, he was discharged to a skilled nursing facility for continued rehabilitation needs.

Conclusions:

It is vital for physicians to understand the risk of untreated advanced FA to address the risk of SCI secondary to this process. Literature involving sequelae related to advanced FA is limited, specifically in the context of spinal cord compression and SCI, and this case study adds to the literature on this rare cause of SCI.