Dural ectasia is a radiological finding characterised by enlargement of the dura in the spinal cord, especially in the lower lumbosacral regions.
The connective tissue weakness in the underlying condition is thought to lead to expansion of the dura from the pulsatile flow of the cerebrospinal fluid. The lower regions are affected because that is where subarachnoid pressure is highest. Dural ectasia can result in bony erosions of the posterior vertebral body, meningoceles, and herniation of nerve root sleeves.
Dural ectasia is a strong indicator of having an inherited connective tissue disorder. The cardinal underlying condition is Marfan Syndrome where it is present in 60% of individuals and is one of the major criteria. However it can also be seen in neurofibromatosis type 1, Ehlers-Danlos syndrome, Loeys-Dietz syndrome, osteogenesis imperfecta, acromegaly, and ankylosing spondylitis. It can also occur post trauma, post surgery, and from tumours.
It is also associated with back pain and lumbar radicular pain and radiculopathy. The bony erosions and meningoceles can cause constipation and/or incontinence. The meningoceles can be anterior to the sacrum and be palpable as an abdominal mass. Other findings include spondylolisthesis, scoliosis, and fractures.
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