Anterior dural ectasia mimicking a lytic lesion in the posterior vertebral body in ankylosing spondylitis

Abstract

<jats:p>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.</jats:p>

Anterior dural ectasia associated with cauda equine syndrome in ankylosing spondylitis: a case report

“…Liu et al [10] described brous tissue with scant lymphoplasma cell in ltration in the dura mater of an AS patient with dural ectasia. Local in ammation leads to a slowly progressive process of bony erosion [11,12] . Furthermore, dural brosis causes diminished resorption of cerebrospinal uid (CSF).…”

“…These changes seem to occur commonly at the level of the thoracolumbar junction and upper lumbar vertebrae [17] . [11] 50 Male 0. Dural ectasia can also be caused by spinal tumor, Marfan syndrome, Ehlers-Danlos syndrome, or neuro bromatosis, but the patient's clinical manifestations and imaging ndings did not support the diagnosis of these disease.…”

“…Liu et al [10] found that little improvement was achieved after performing deadhesion of the tethered conus medullaris. Bele et al [11] suggested releasing the arachnoid adhesions and brosis around the cauda equina roots, which may lead to deterioration of neurological function.…”

“…Although it is not clear whether LPS is effective for anterior dural ectasia, Bele et al [11] suggested performing LPS, as the pathogenesis for an anterior and posterior dural ectasia remains the same.…”

Marsupialization and distal obliteration of a lumbosacral dural ectasia in a nonsyndromic, adult patient

“…Dural ectasia involves the enlargement of the spinal canal, concavity of the posterior vertebral body, reduction of cortical bone thickness of the pedicles and laminae, expansion of the neural foramina, formation of a meningocele, scoliosis, spondylolithesis, or vertebral fractures. [ 1 ] Lumbosacral dural ectasia is commonly associated with connective tissue disorders, such as Marfan syndrome,[ 2 3 4 5 6 7 8 9 ] osteogenesis imperfecta, Loeys-Dietz syndrome,[ 10 11 12 13 14 ] ankylosing spondylitis (AS),[ 15 16 ] neurofibromatosis,[ 17 18 ] fibromuscular dysplasia,[ 19 ] and Larsen syndrome;[ 20 ] however, the pathology has also been linked to vertebral fracture, spine surgery,[ 21 ] trisomy 13,[ 22 ] scoliosis,[ 23 ] and trauma.…”