Dural ectasia

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Dural ectasia refers to ballooning or widening of the dural sac which can result in posterior vertebral scalloping and is associated with herniation of nerve root sleeves.

Clinical presentation

Patients with dural ectasia may present with low back pain or radicular pain in the buttocks or legs. Pain may be accompanied by leg weakness or urinary incontinence. Other associations include spondylolisthesis, scoliosis, vertebral erosions and vertebral fractures. There is also an increased incidence of anterior sacral meningocoeles which may present as an abdominal mass.

Associations

Marfan syndrome: dural ectasia has been observed in 60-90% of patients; in these patients, the dilatation of the dural sac is almost always in the lumbar region
neurofibromatosis type 1
Ehlers-Danlos syndrome
ankylosing spondylitis
osteogenesis imperfecta
trauma
post surgery
tumours
scoliosis

Radiographic features

Dural ectasia is dilatation of the dural sac. Anteroposterior diameter of the thecal sac at the S1 level greater than that of the thecal sac at the L4 level.

Plain film

Posterior vertebral scalloping may be an indirect indicator ^1-2. However, this is not specific, as it is seen in a significant percentage of the normal population and is also associated with several other conditions.

MRI

Increase in the AP diameter of the dural sac, usually in the lumbar region.

^{Differantial diagnosis}

^{Tarlov cyst}

-</ul><h4>Radiographic features</h4><h5>Plain film</h5><p>Posterior <a href="/articles/vertebral-scalloping">vertebral scalloping</a> may be an indirect indicator <sup>1-2</sup>. However, this is not specific, as it is seen in a significant percentage of the normal population and is also associated with several other conditions.</p><h5>MRI</h5><p>Increase in the AP diameter of the dural sac, usually in the lumbar region.</p>
+</ul><h4>Radiographic features</h4><p>Dural ectasia is dilatation of the dural sac. Anteroposterior diameter of the thecal sac at the S1 level greater than that of the thecal sac at the L4 level.</p><h5>Plain film</h5><p>Posterior <a href="/articles/vertebral-scalloping">vertebral scalloping</a> may be an indirect indicator <sup>1-2</sup>. However, this is not specific, as it is seen in a significant percentage of the normal population and is also associated with several other conditions.</p><h5>MRI</h5><p>Increase in the AP diameter of the dural sac, usually in the lumbar region.</p><h4><sup>Differantial diagnosis</sup></h4><ul><li><a title="Tarlov cysts" href="/articles/tarlov-cyst"><sup>Tarlov cyst</sup></a></li></ul>

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