From the Department of Neurology, National Neuroscience Institute, Singapore.
Department of Radiology, Khoo Teck Puat Hospital, Singapore.
Sex Transm Dis. 2021 Sep 1;48(9):e126-e131. doi: 10.1097/OLQ.0000000000001391.
Syphilitic spinal disease is a rare condition caused by the spirochete Treponema pallidum, either from direct spirochete involvement of the cord or as a consequence of indirect spirochete involvement of the meninges, blood vessels, or the vertebral column. After the introduction of penicillin therapy in the 1940s, it has become an increasingly rare condition. We report 3 challenging cases of syphilitic spinal disease presenting as myelopathy-1 with an extra-axial gumma of tertiary syphilis causing cord compression and 2 with tabes dorsalis complicated by tabetic spinal neuroarthropathy-each presenting a diagnostic dilemma to their treating physicians. We also review the literature for updates on modern investigative modalities and discuss pitfalls physicians need to avoid to arrive at the diagnosis.
梅毒脊髓病是一种罕见的疾病，由梅毒螺旋体引起，可能是由于脊髓直接受到螺旋体的侵袭，也可能是由于脑膜、血管或脊柱间接受到螺旋体的侵袭。20 世纪 40 年代青霉素治疗问世后，这种疾病变得越来越少见。我们报告了 3 例具有挑战性的梅毒脊髓病病例，表现为脊髓病，1 例为三期梅毒的硬膜外树胶肿导致脊髓压迫，2 例为脊髓痨合并糖尿病性脊髓神经关节病，每位患者的治疗医生都面临着诊断上的困境。我们还回顾了文献中关于现代检查方法的更新，并讨论了医生在诊断过程中需要避免的误区。
