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Abstract：
BACKGROUND Charcot spine (CS), also called neuropathic arthropathy, appears to be triggered by damage to the nervous system (either central or peripheral) impairing proprioception and pain/temperature sensation in the vertebral column. Therefore, the defense mechanisms of altered joints lead to a progressive degeneration of the vertebral joint and surrounding ligaments, which can provoke major spinal instability. Beyond the sensory aspects, mechanic factors are identified as risk factors. While its etiology and pathophysiology remain contested, CS represents a rare and difficult pathology to diagnose at an early stage, owing to its nonspecific clinical symptoms. The diagnosis of CS is probably still underestimated and often occurs only quite late in the disease course. CASE REPORT 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. 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. CONCLUSIONS This case report demonstrates the benefits of early diagnosis of CS when confronted by the clinical and radiological criteria. Therefore, it seems important to be able to evoke this neuropathic spinal arthropathy sufficiently in time to prevent its disabling consequences in patients with spinal cord injury, in terms of quality of life and independence.
摘要：
背景Charcot脊柱（CS），也被称为神经病性关节病，似乎是由神经系统（中枢或外周）受损引起的，损害了脊柱的本体感觉和疼痛/温度感觉。因此,改变关节的防御机制导致椎体关节和周围韧带的进行性变性，这会引起严重的脊柱不稳定。除了感官方面，机械因素被确定为危险因素。虽然其病因和病理生理学仍存在争议，CS代表一种罕见且难以早期诊断的病理，由于其非特异性临床症状。CS的诊断可能仍然被低估，并且通常仅在疾病过程中很晚才发生。病例报告一名有创伤后四肢瘫痪病史的83岁男性患者在3年后被诊断为CS，在描述了最近神经性疼痛的进行性恶化之后。诊断比文献中描述的大多数病例更早。的确,在最近的一篇评论中，神经功能缺损发病与CS诊断之间的平均时滞为17.3±10.8年.结论本病例报告证明了当面对临床和放射学标准时，早期诊断CS的益处。因此,似乎重要的是能够及时引起这种神经性脊柱关节病，以防止其在脊髓损伤患者中的致残后果，在生活质量和独立性方面。
