Spinal deformity associated with dural ectasia in individuals with Marfan syndrome: a cross-sectional comparative study (MarfanEOS)

To compare spinal and pelvic parameters obtained on a full spine x-ray in standing position using the EOS ® system, between individuals with Marfan syndrome with and those without dural ectasia. We conducted a cross-sectional comparative study of individuals with Marfan syndrome with and without dural ectasia. Individuals with Marfan syndrome previously included in the MarfanLomb study and those followed-up from June 2023 to June 2025 in a physical and rehabilitation medicine department were screened. The presence of dural ectasia was assessed using computerized tomography scan or magnetic resonance imaging. Endpoints were: 1/ frequencies of Sponseller’s classification types, 2/ frequencies and quantification of scoliosis and of sagittal and coronal global imbalance, and 3/ pelvic parameters. Overall, 31 individuals were included: 19 (61%) had dural ectasia and 12 (39%) had not. Mean age was 45 (11) years, 17 (55%) were women and 2 (13%) had a history of back surgery. Types IC (thoracic kyphosis ≥ 50°) and IIB (inversed sagittal curves with lumbar kyphosis) of Sponseller’s classification were more frequent in individuals without dural ectasia that in those with (4 [33%] vs. 1 [6%], p = 0.04 and 3 [25%] vs. 0 [0%], p = 0.02, respectively). We found no differences between the two groups for other outcomes assessed. Individuals with Marfan syndrome without dural ectasia, as compared to individuals with Marfan syndrome with dural ectasia, more often display types IC (thoracic kyphosis ≥ 50°) and IIB (inversed sagittal curves) of Sponseller’s classification.