Clinical introduction

A 75-year-old man presented with acute onset thoracic back pain, progressive leg weakness with numbness and urinary retention. His symptoms started suddenly and progressed overnight. He denied a recent history of trauma. On neurological examination he had complete loss of all sensations below Th10 level and leg paraplegia (American Spinal Injury Association grade A myelitis). Admission lateral spine X-ray and non-contrast CT were performed (figures 1 and 2).