Case questions

1. Case 8

2. History
30 year old female presented with history of back pain for last 1
year. Initially the pain was insidious in onset and progressed over
a period of time. For last 4 months she is complaining of Urinary
incontinence She has weakness in both her lower limbs although
she is able to manage to walk.
Do you want any additional history?
What is your differential diagnosis?

3. Examination
The spine is stiff and painful on movement, with localized
kyphotic deformity that would be tender on percussion. There is
a persistent paraspinal muscle spasm

4. • Bilateral lower limb weakness.
• Exaggerated reflexes
• Extensor planatar response
• Sensations are intact

5. Imaging

6. Imaging

7. Diagnosis?
Management?