[Ossifying arachnoiditis in spondyloarthropathy patient]

Area of Science:

• Neurology
• Rheumatology
• Spinal Cord Medicine

Background:

• Ankylosing Spondylitis (AS) is a chronic inflammatory disease primarily affecting the spine.
• Neurological complications in AS are uncommon but can be debilitating.
• Long-term spinal inflammation can lead to secondary conditions affecting the spinal cord.

Observation:

• A 52-year-old male with a 30-year history of Ankylosing Spondylitis presented with progressive neurological deficits.
• Symptoms included lower limb paresthesias, sensory impairment, muscle weakness, and autonomic dysfunction (bladder, bowel, sexual).
• Severe spinal lesions were identified, including epidural calcification, spinal cord compression, and syringomyelia from D1 to L5.

Findings:

• The patient's neurological decline was directly linked to extensive epidural calcification and resultant spinal cord compression.
• Syringomyelia, a fluid-filled cyst within the spinal cord, was observed as a consequence of the chronic compression.
• These findings underscore a severe, albeit rare, spectrum of neurological involvement in long-standing Ankylosing Spondylitis.

Implications:

• This case emphasizes the need for vigilant neurological monitoring in patients with Ankylosing Spondylitis.
• Early detection and management of spinal cord compression and related complications are crucial to prevent irreversible neurological damage.
• Understanding these neurological manifestations is vital for comprehensive patient care and treatment strategies in AS.