Study Design. A cross-sectional age- and sex-matched study comparing the pr
evalence and size of dural ectasia in two groups of patients with Marfan sy
ndrome. Group I comprised patients with moderate to severe back pain and Gr
oup II comprised patients without back pain.
Objectives. To determine whether the presence and size of dural ectasia is
associated with back pain in patients with Marfan syndrome.
Summary of Background Data. Dural ectasia is present in more than 60% of pa
tients with Marfan syndrome. Moderate to severe back pain is present in mor
e than 50% of patients with Marfan syndrome. Most cases of significant low
back pain in patients with Marfan syndrome do not have a clear cause. It wo
uld be useful for the clinician to know whether dural ectasia may be a caus
e of back pain in patients with Marfan syndrome with no other source.
Methods. Thirty two volunteers aged 30-50 with Marfan syndrome were enrolle
d as age- and sex-matched pairs with significant back pain (Group 1) and wi
thout back pain (Group II). A completed questionnaire, physical examination
and magnetic resonance image of the lumbosacral spine were obtained. Dural
volume caudal to L5 was calculated from the magnetic resonance data by spe
cially designed software.
Results. Dural ectasia was present in 76% of the patients in Group I, and 4
1% of the patients in Group II. The proportion of patients with dural ectas
ia was significantly higher in Group I. Furthermore, the mean dural volume
was significantly higher in Group I, and a significant correlation between
dural volume and Oswestry pain score was noted;
Conclusions The presence and size of dural ectasia are associated with back
pain in the Marfan syndrome. However, a high prevalence of dural ectasia (
41%) exists even in patients with Marfan syndrome without back pain, The me
re presence of dural ectasia therefore does not necessarily mean the patien
t will be symptomatic even though the two are associated.