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The Cauda Equina Syndrome of Ankylosing Spondylitis

M. LYNN RUSSELL, M.D., F.R.C.P.(C); DUNCAN A. GORDON, M.D., F.R.C.P.(C), F.A.C.P.; METRO A. OGRYZLO, M.D., F.R.C.P.(C); and ROBERT S. McPHEDRAN, M.D., F.R.C.P.(C)
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▸Requests for reprints should be addressed to Duncan A. Gordon, M.D., University of Toronto Rheumatic Disease Unit, The Wellesley Hospital, Toronto, Ontario, Canada.


Ann Intern Med. 1973;78(4):551-554. doi:10.7326/0003-4819-78-4-551
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The occurrence of the cauda equina syndrome with long-standing ankylosing spondylitis is a little-known association that may be overlooked or misdiagnosed. Three patients are reported and compared with ten from the literature. The syndrome has been characterized by the insidious onset of leg or buttock pain, with sensory and motor impairment, in association with bowel or bladder symptoms. Patients were usually unaware of sensory deficits until tested. Genitourinary complaints in most cases led erroneously to prostatic surgery. Characteristic myelographic abnormalities were posterior lumbar diverticula, best shown in the supine position. Corticosteroid therapy in one of our cases and laminectomy in two others had no effect on the course of this slowly progressive process. Greater awareness of the cauda equina syndrome of ankylosing spondylitis should lead to earlier recognition of the association.

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