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Congenital insensitivity to pain with anhidrosis (CIPA) is associated with Charcot arthropathy and is a rare clinical syndrome, with limited treatment options. Through a decade-long follow-up of a single case, we aim to provide new insights for clinicians regarding the choice of surgical strategies and postoperative complications. The diagnosed patient exhibited congenital insensitivity to pain and anhidrosis, accompanied by severe Charcot arthropathy affecting the spine. Multiple postoperative complications, including implant displacement, adjacent segment pathology, and pedicle screw loosening, occurred after surgical intervention, leading to five subsequent revision surgeries. Considering the limited experience in managing CIPA-related Charcot spinal arthropathy in the literature, surgical correction remains the preferred treatment. Among the 16 cases reviewed, common postoperative complications included implant displacement, adjacent segment pathology, and pedicle screw loosening. Based on current experience, we do not recommend extensive resection and reconstruction after removing the affected vertebral body, as this may increase the risk of implant displacement. Instead, a 360° long-segment fusion may help reduce the risk of adjacent segment degeneration. Additionally, we discuss potential reasons for revision surgery after Charcot spinal arthropathy surgery and perioperative management strategies for such cases. Meticulous care, appropriate rehabilitation exercises, and metabolic therapy for bone mineralization are crucial components of the treatment for this condition.

Objective: To explore the correlation between the stability of lumbar vertebrate and pelvic indices of pelvic incidence (PI), lumber lordosis (LL), pelvic tilt (PT) and sacrum slope (SS)., Methods: The preoperative imaging data were analyzed retrospectively for 78 patients with lumbar disc protrusion. The values of PI, PT, SS and LL were measured and compared between lumbar vertebrate stability and lumbar vertebrate instability groups., Results: No inter-group statistical difference existed in PI, LL, PT or SS. The average PI of lumbar vertebrate instability group was higher than that of lumbar vertebrate stability group.In patients with L4/5 segmental lesion, SS of lumbar vertebrate instability group was higher than that of lumbar vertebrate stability group (38.7 ± 4.7)° vs (34.0 ± 6.6)°, P = 0.023. And PT in patients with L5/S1 segmental lesion was higher than those with L4/5 segmental lesion (17.5 ± 7.0 vs 14.9 ± 5.3, P = 0.027)., Conclusion: No statistical inter-group difference exists in PI. However, higher SS and PT may be risk indicators of instability for L4/5 and L5/S1 segments respectively.