Dural ectasia - neurofibromatosis

Case contributed by Dr Ian Bickle

Presentation

Neurofibromatosis type 1 patient. Prior soft tissue collection. Immobilized with bedsore.

Patient Data

Age: 50 years
Gender: Male

Marked dural ectasia of the lower lumbar spine from the level of L3 down to the coccyx. This is most pronounced at the sacral level with a canal diameter of 10.5 cm.

Posterior scalloping at L4, L5 and the sacral level.

Established endplate fractures of T12, L2 and L4.

Long-standing scarring/soft tissue disruption in the left buttock involving the subcutaneous tissues and the gluteal muscles.

Catheterized grossly thickened bladder. No hydronephrosis.

Case Discussion

These following inferences can be inferred in this patient with known neurofibromatosis:

  1. Dural ectasia and posterior vertebral scalloping - both associated with neurofibromatosis.
  2. A neuropathic bladder - due to the consequences of neurofibromatosis
  3. Chronic changes in soft tissues of the left buttock from a prior complex soft tissue infection due to immobilization due to spinal disease. No acute osteomyelitis of soft tissue collection.

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