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.