Lumbar radiculopathy in ankylosing spondylitis with dural ectasia

Kotıl, Kadır; Yavaşca, Pınar

doi:10.1016/j.jocn.2006.07.005

Cited by 19 publications

(7 citation statements)

References 14 publications

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“…It has been suggested that the defective fibrillin leading to abnormally weak connective tissues cause weakness and dilatation of the dural sac [11]. On the one hand, it has also been proposed that chronic peridural inflammation due to ankylosing spondylitis, could weaken the dural sac and result in dural ectasia [3]. Studies have reported that dural ectasia could occur after spinal surgery (if patients had no medical history of connective tissue disorders or ankylosing spondylitis) [5,12].…”

Section: Discussionmentioning

confidence: 99%

“…The etiology of dural ectasia is not well known, but it is usually observed in patients with connective tissue disorders such as Marfan syndrome, Ehlers-Danlos syndrome, neurofibromatosis 1, and ankylosing spondylitis [1][2][3][4]. In contrast, some studies suggest that dural ectasia can originate from vertebral fractures, spine surgeries, scoliosis, and traumas [5,6].…”

Section: Introductionmentioning

confidence: 99%

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A Case of Dural Ectasia with Low Back Pain and Sciatica Treated with Integrative Korean Medical Treatment

et al. 2019

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Dural ectasia is defined as ballooning or expansion of the dural sac surrounding the spinal cord. This report describes a rare case of low back pain and sciatica, suspected as being dural ectasia. The patient was hospitalized for 45 days, and underwent integrative Korean medical treatment, including pharmacopuncture, acupuncture, herbal medicine, Chuna therapy, cupping therapy, and physiotherapy. The effect of the treatment was evaluated using the numerical rating scale, Oswestry disability index, European quality of life 5 dimensions, and subjective symptoms. After inpatient treatment, the pain the patient experienced was significantly reduced and the evaluation indices improved. This case report suggested that integrative Korean medical treatment could be an effective therapeutic choice for low back pain and sciatica, with dural ectasia. Further clinical studies are needed to support this observation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Case of Dural Ectasia with Low Back Pain and Sciatica Treated with Integrative Korean Medical Treatment

et al. 2019

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“…Possible pathogenic mechanisms include inflammation and arachnoiditis (with subsequent fibrosis and formation of dural ectasia), mechanical stretching and compression of the nerve roots (by dural ectasia or arachnoid cysts, or secondary to an arterial pulse wave), reduced compliance of the caudal sac and a demyelination due to radiotherapy or ischaemia [2-10]. …”

Section: Discussionmentioning

confidence: 99%

Destructive Dural Ectasia of Dorsal and Lumbar Spine with Cauda Equina Syndrome in a Patient with Ankylosing Spondylitis~!2010-06-04~!2010-06-24~!2010-08-26~!

Hoydonck¹,

Vlam²,

Westhovens³

et al. 2010

TORJ

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We present a patient with longstanding ankylosing spondylitis complicated with cauda equina syndrome. The patient suffered from increasing pain in the leg with reduced sensitivity and extremely cold feet associated with incontinence. Diagnostic workup revealed dural ectasia, arachnoiditis and a spinal inflammatory mass leading to extensive vertebral bone destruction. Of interest, this was not only found in the lumbar spine region (which is typical in cases of cauda equina syndrome associated with ankylosing spondylitis) but also in the lower cervical spine (C7) and upper dorsal spine. Moreover, the bone destructive phenotype of this complication of long-standing AS contrasts with the usual characteristics of new bone formation and ankylosis. As initial treatment with anti-inflammatory drugs was not sufficiently successful, infliximab therapy was started which resulted in manifest clinical improvement as chronic pain, incontinence and laboratory signs of inflammation progressively disappeared.

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“…Thus, neuropathies can be compressive, causing carpal tunnel syndrome, posterior interosseous nerve palsy, and cubital tunnel syndrome [3,8], or noncompressive; the latter are seen in up to 20 % of patients with RA and present as mononeuritis multiplex (presumably due to vasculitis), distal sensory and sensorimotor axonal neuropathy [3,8], or smallfiber sensory neuropathy. In other inflammatory arthritis, including psoriatic arthritis and AS, entrapment neuropathies can also occur; in the case of AS these are mainly radiculopathies [70,71].…”

Section: Inflammatory Arthritismentioning

confidence: 99%

Immunotherapies for Neurological Manifestations in the Context of Systemic Autoimmunity

et al. 2016

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Neurological involvement is relatively common in the majority of systemic autoimmune diseases and may lead to severe morbidity and mortality, if not promptly treated. Treatment options vary greatly, depending on the underlying systemic pathophysiology and the associated neurological symptoms. Selecting the appropriate therapeutic scheme is further complicated by the lack of definite therapeutic guidelines, the necessity to differentiate primary neurological syndromes from those related to the underlying systemic disease, and to sort out adverse neurological manifestations caused by immunosuppressants or the biological agents used to treat the primary disease. Immunotherapy is a sine qua non for treating most, if not all, neurological conditions presenting in the context of systemic autoimmunity. Specific agents include classical immune modulators such as corticosteroids, cyclophosphamide, intravenous immunoglobulin, and plasma exchange, as well as numerous biological therapies, for example antitumor necrosis factor agents and monoclonal antibodies that target various immune pathways such as B cells, cytokines, and co-stimulatory molecules. However, experience regarding the use of these agents in neurological complications of systemic diseases is mainly empirical or based on small uncontrolled studies and case series. The aim of this review is to present the state-of-the-art therapies applied in various neurological manifestations encountered in the context of systemic autoimmune diseases; evaluate all treatment options on the basis of existing guidelines; and compliment these data with our personal experience derived from a large number of patients.

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Lumbar radiculopathy in ankylosing spondylitis with dural ectasia

Cited by 19 publications

References 14 publications

A Case of Dural Ectasia with Low Back Pain and Sciatica Treated with Integrative Korean Medical Treatment

A Case of Dural Ectasia with Low Back Pain and Sciatica Treated with Integrative Korean Medical Treatment

Destructive Dural Ectasia of Dorsal and Lumbar Spine with Cauda Equina Syndrome in a Patient with Ankylosing Spondylitis~!2010-06-04~!2010-06-24~!2010-08-26~!

Immunotherapies for Neurological Manifestations in the Context of Systemic Autoimmunity

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