Slow ascending myelopathy, tetraplegia, carcinoma of the bladder and amyloidosis in a patient with ankylosing spondylitis

Objective: We report a case of slow ascending myelopathy in a patient with ankylosing spondylitis (AS). Design: Case report of a 60-year-old patient suffering from AS, who developed over a period of 30 years a slow ascending myelopathy leading to tetraplegia, squamous cell carcinoma of the bladder and amyloidosis of the small intestine secondary to neuropathic bladder and bowel. Setting: Department and Outpatient's Department of Neurological Rehabilitation Sheba Medical Center, Tel Hashomer, Israel. Subject: Single patient case report. Main outcome measure: Clinical follow-up of the patient between the years 1959-1998. Results: Physical examination disclosed deteriorating incomplete tetraplegia with hypotonia and hyporreflexia. Neurogenic bladder and bowel complicated to squamous cell carcinoma and amyloidosis. Conclusion: To our knowledge, flaccid tetraplegia associated with AS, has never been reported in the literature. The possibility of vascular compression bq the ankylosed spine causing the clinical picture of flaccid tetraplegia in this patient is discussed.