Tertiary syphilis in the lumbar spine: a case report
نویسندگان
چکیده
BACKGROUND The incidence of tertiary syphilis involvement in the spinal column with destructive bone lesions is very rare. It is difficult to establish the correct diagnosis from radiographs and histological examination alone. Limited data are available on surgical treatment to tertiary syphilitic spinal lesions. In this article, we report a case of tertiary syphilis in the lumbar spine with osteolytic lesions causing cauda equina compression. CASE PRESENTATION A 44-year-old man who suffered with low back pain for 6 months and progressive radiating pain at lower extremity for 1 week. Radiologic findings showed osteolytic lesion and new bone formation in the parts of the bodies of L4 and L5. Serum treponema pallidum hemagglutination (TPHA) test was positive. A surgery of posterior debridement, interbody and posterolateral allograft bone fusion with instrumentation from L3 to S1 was performed. The low back pain and numbness abated after operation. But the follow-up radiographs showed absorption of the bone grafts and failure of instrumentation. A Charcot's arthropathy was formed between L4 and L5. CONCLUSION It is challenging to diagnose the tertiary syphilis in the spine. Surgery is a reasonable auxiliary method to antibiotic therapy for patients who suffered with neuropathy. Charcot's arthropathy should be considered as an operative complication.
منابع مشابه
Diffuse Idiopathic Skeletal Hyperostosis Involving Cervical and Lumbar Spine Presenting with Dysphagia: A Case Report
Introduction: Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a very rare cause of dysphagia when it occurs in the cervical spine. It can also affect the lumbar region where it causes deformity. Case Report: In this article, a rare case of Diffuse Idiopathic Skeletal Hyperostosis involving both the cervical and lumbar spine, presenting with dysphagia and spinal stiffness leading to a stoopin...
متن کاملTertiary Syphilis in the Cervical Spine: A Case Report and Review of the Literature
As the prevalence of syphilis rises, an increase in tertiary syphilis with spinal involvement is predicted. We report what we believe to be the first case of compressive cervical spine syphilitic gummata, with central cord compression signs. We also review the relevant literature to date. The diagnosis of syphilis in the spine relies on the physician to be aware of it as part of the differentia...
متن کاملReport of a Case: An Intradural between Roots Capillary Hemangioma of Cauda Equina
Background & Importance: Cavernous angiomas are typically superficial lesionscreated by anomalous vessels and found in the skin or mucosa, but intradural locations are rare especially in the spine. We report a case of the spinal intradural Cavernous angiomas of the lumbar spine. Case Presentation: A 53-year-old man presented with a 6-month history of low back pain and bilateral radicular pai...
متن کاملSyphilis of the lumbar spine
RATIONALE Tertiary syphilis can manifest as gummatous disease, but gumma of the spine has been extremely rarely reported. PATIENT CONCERNS A 61-year-old male complained of worsening pain and numbness in both lower legs for four weeks. DIAGNOSES Syphilis of the Lumbar Spine. INTERVENTIONS Pedicle screw fixation (L3-S1) and posterior decompression of the vertebral canal at L4-5 were perform...
متن کاملMultiple lumbar vertebral fractures following a single idiopathic seizure in an otherwise healthy patient a case report
It has been reported that fractures are more common in epileptic patients relative to the general population. Seizures by repeated muscular contractions can increase fracture risk throughout the skeleton, but the reported papers about non traumatic vertebral fractures following a single episode of seizure are rare and mostly located in thoracic spine with only one or two vertebral fr...
متن کامل