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Interventional Spine Considerations for Dural Ectasia in a Patient With Marfan Syndrome

Kohns David J. DO
American Journal of Physical Medicine & Rehabilitation: Post Author Corrections: March 27, 2017
doi: 10.1097/PHM.0000000000000738
Case Report: PDF Only

Abstract

For patients with Marfan syndrome who present with radicular low back pain, interventional spine providers should be familiar with dural ectasia with variable diffuse thinning of the posterior wall of the lumbar spine and sacrum. Providers should carefully weigh the risks and benefits of offering elective procedures because altered anatomy may put these patients at higher risk of dural puncture. Patient selection is essential because hydrostatic pressures and/or neural tension should also be considered as potential pain generators that may not be relieved by steroid injections. Careful evaluation of recent magnetic resonance images and vigilant procedural technique is highly recommended.

All correspondence and requests for reprints should be addressed to: David J. Kohns, DO, Department of Physical Medicine and Rehabilitation, University of Michigan, 325 E Eisenhower Parkway, SPC 5744, Ann Arbor, MI 48408.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the author or by any individuals in control of the content of this article.

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