Early Diagnosis of Late-Onset Below-Level Neuropathic Pain in an 83 Year-Old Incomplete Tetraplegic Patient: A Charcot Spinal Neuro-Arthropathy Case Report

Charcot spine (CS), also called neuropathic arthropathy, appears to be triggered by damage to the nervous system impairing proprioception and pain/temperature sensation in the vertebral column. The diagnosis of CS is probably still underestimated and often occurs only quite late in the disease course. This case report demonstrates the benefits of early diagnosis of CS when confronted by the clinical and radiological criteria.

• 1
  An 83-year-old male patient who had a history of a post-traumatic tetraplegia was diagnosed with CS after 3 years, after describing a recent progressive worsening of neuropathic pain.
• 2
  The diagnosis was earlier than the majority of cases described in the literature. Indeed, in a recent review, the mean time lag between the onset of neurological impairment and the diagnosis of CS was 17.3±10.8 years.
• 3
  The patient showed characteristic clinical (spinal pain, walking imbalance, changes in neurological status) and radiological signs (important disc degeneration, vertebral degeneration that mirrors the disc space, destruction of facet joints, and osteophytosis within paravertebral soft tissues) of the CS.