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

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 con...

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Autores principales: Huang, Zhi-Xiang, Deng, Wei-Ming, Guo, Xin, Lin, Chu-Lan, Li, Tian-Wang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6421385/
https://www.ncbi.nlm.nih.gov/pubmed/30782057
http://dx.doi.org/10.1177/0300060519827701
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author Huang, Zhi-Xiang
Deng, Wei-Ming
Guo, Xin
Lin, Chu-Lan
Li, Tian-Wang
author_facet Huang, Zhi-Xiang
Deng, Wei-Ming
Guo, Xin
Lin, Chu-Lan
Li, Tian-Wang
author_sort Huang, Zhi-Xiang
collection PubMed
description 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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spelling pubmed-64213852019-03-22 Lumbar bone erosion with anterior dural ectasia in ankylosing spondylitis: a case report Huang, Zhi-Xiang Deng, Wei-Ming Guo, Xin Lin, Chu-Lan Li, Tian-Wang J Int Med Res Case Reports 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. SAGE Publications 2019-02-19 2019-03 /pmc/articles/PMC6421385/ /pubmed/30782057 http://dx.doi.org/10.1177/0300060519827701 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Reports
Huang, Zhi-Xiang
Deng, Wei-Ming
Guo, Xin
Lin, Chu-Lan
Li, Tian-Wang
Lumbar bone erosion with anterior dural ectasia in ankylosing spondylitis: a case report
title Lumbar bone erosion with anterior dural ectasia in ankylosing spondylitis: a case report
title_full Lumbar bone erosion with anterior dural ectasia in ankylosing spondylitis: a case report
title_fullStr Lumbar bone erosion with anterior dural ectasia in ankylosing spondylitis: a case report
title_full_unstemmed Lumbar bone erosion with anterior dural ectasia in ankylosing spondylitis: a case report
title_short Lumbar bone erosion with anterior dural ectasia in ankylosing spondylitis: a case report
title_sort lumbar bone erosion with anterior dural ectasia in ankylosing spondylitis: a case report
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6421385/
https://www.ncbi.nlm.nih.gov/pubmed/30782057
http://dx.doi.org/10.1177/0300060519827701
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