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A Journal on Surgery

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Chirurgia 2013 October;26(5):369-71

language: English

A late diagnosis of tabes dorsalis after lumbar disc surgery: a case report and review of the literature

Tian D.-S. 1, 2, Jing J.-H. 2, Qian J. 2, Li J.-M. 1

1 Department of Orthopedics Qilu Hospital Affiliated to Shandong University Jinan, P.R. China;
2 Department of Orthopaedics Second Hospital Affiliated to Anhui Medical University Hefei, China


Tabes dorsalis is extremely rare, especially when it is associated with lumbar disc herniation. We report the case of a 45-year-old man with lumbar disc herniation and tabes dorsalis. There was considerable delay in the diagnosis and surgical intervention because syphilis was not considered as the cause of the signs and symptoms. The cases involving the diagnosis and treatment of tabes dorsalis with lumbar disc herniation are limited. Lumbar disc herniation may accompany tabes dorsalis. Tabes dorsalis should be ruled out when imaging studies show lumbar disc herniation in the setting of positive Treponema pallidum titers despite non-classical clinical symptoms and signs of syphilis. In this clinical scenario, syphilis treatment should be initiated immediately. The decision to pursue surgical intervention should be based on whether there is regional compression of the nerve roots or the spinal cord and on whether the clinical symptoms are improving.

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