Lumboperitoneal shunt for treatment of dural ectasia in ankylosing spondylitis

Anterior dural ectasia is an extremely rare finding in ankylosing spondylitis (AS). The authors describe a unique case of AS in which the patient presented with cauda equina syndrome as well as an unusual imaging finding of erosion of the posterior aspect of the L-1 (predominantly) and L-2 vertebral bodies due to anterior dural ectasia. Symptomatic patients with long-standing AS should be monitored for the presence of dural ectasia, which can be anterior in location, as is demonstrated in the present case.

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Cauda equina syndrome and dural ectasia: rare manifestations in chronic ankylosing spondylitis

British Journal of Radiology ◽

10.1259/bjr/45816561 ◽

2011 ◽

Vol 84 (1002) ◽

pp. e123-e125 ◽

Cited By ~ 18

Author(s):

C-C Liu ◽

Y-C Lin ◽

C-P Lo ◽

T-P Chang

Keyword(s):

Ankylosing Spondylitis ◽

Cauda Equina Syndrome ◽

Cauda Equina ◽

Dural Ectasia

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DURAL ECTASIA, LUMBAR RADICULOPATHY AND ANKYLOSING SPONDYLITIS – CASE REPORT OF A RARE MANIFESTATION

10.26226/morressier.5f5a58d42c3338b5c13cd16c ◽

2020 ◽

Author(s):

Joana Tavares ◽

Tiago Lorga

Keyword(s):

Case Report ◽

Ankylosing Spondylitis ◽

Lumbar Radiculopathy ◽

Dural Ectasia ◽

Rare Manifestation

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Lumbar bone erosion with anterior dural ectasia in ankylosing spondylitis: a case report

Journal of International Medical Research ◽

10.1177/0300060519827701 ◽

2019 ◽

Vol 47 (3) ◽

pp. 1395-1400

Author(s):

Zhi-Xiang Huang ◽

Wei-Ming Deng ◽

Xin Guo ◽

Chu-Lan Lin ◽

Tian-Wang Li

Keyword(s):

Ankylosing Spondylitis ◽

Bone Erosion ◽

Posterior Part ◽

Nerve Tissue ◽

Lytic Lesion ◽

Lumbar Spinal Cord ◽

Dural Defect ◽

Dural Ectasia ◽

Spinal Cord Herniation ◽

Vertebral Bodies

Bony erosion and dural ectasia rarely occur in the posterior part of the vertebral body in ankylosing spondylitis (AS). Because of the compression of nerve tissue that adheres to the inflamed dura mater, a range of neurologic symptoms may develop. Few studies have investigated therapies for this condition, and surgical intervention might alleviate the neurologic dysfunction. Here, we report an uncommon case of lumbar spinal cord herniation secondary to anterior dural ectasia in a patient with AS. The patient had a 31-year history of AS and presented with progressive numbness and weakness of his left leg that had lasted for nearly 1 month. Magnetic resonance imaging (MRI) revealed a dural defect in the posterior aspect of the L1 and L2 vertebral bodies, with displacement of the nerve tissue adjacent to the lytic lesion. The patient declined surgery and was prescribed oral meloxicam. The neurological symptoms of the left leg remained stable during 2 years of follow-up. The dural enhancement on MRI resolved, although the erosion-like lesion in the vertebral bodies persisted. This unusual case supports the central role of inflammation in anterior dural ectasia of patients with AS. Anti-inflammatory treatment may be an alternative therapy for patients who decline surgery.

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