IMAGING FINDINGS IN SPINAL NEUROARTHROPATHY

Study Design. The literature is reviewed and five case reports are pre sented. Objective. The objective was to review and emphasize the chara cteristic magnetic resonance imaging and radiologic findings. Summary of Background Data. Spinal neuroarthropathy is a destructive process i nvolving the disc space, the adjoining vertebral bodies, and the facet joints that can be induced by traumatic paralysis as well as tabes do rsalis, syringomyelia, and diabetes mellitus. Methods. Five cases of n europathic spine in two patients with quadriplegia and three patients with paraplegia from the authors' spinal cord unit were reviewed. Resu lts. On plain radiographs and computed tomography scans, the findings of neuropathic spire were similar to those of disc space infection, se vere degenerative disease, and skeletal metastasis. Magnetic resonance imaging, however, showed characteristic hypointensity of signal on T1 - and T2-weighted images, which makes it possible to differentiate neu ropathic spine and infection. Conclusions. In neuropathic spine, neuro pathic destructive changes in the vertebral bodies lead to fracture, f ollowed by additional changes, including bone sclerosis, large osteoph ytes, and loss of disc space. A large paraspinal mass develops because of improper fracture healing. At the end stage of this process, a pse udarthrosis may form, as was evident in three of the five patients rev iewed.