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dolescents should reinforce these gains. Syphilitic spinal disease is a rare condition caused by the spirochete Treponema pallidum, either from direct spirochete involvement of the cord, or as a consequence of indirect spirochete involvement of the meninges, blood vessels, or the vertebral column. Following the introduction of penicillin therapy in the 1940s, it has become an increasingly rare condition. We report three challenging cases of syphilitic spinal disease presenting as myelopathy - one with an extra-axial gumma of tertiary s
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