Mr Anderson has a background of known metastatic prostate cancer.He presented with pain in his lower back, tingling in his legs and difficulty passing urine.On examination of the lower limbs tone was increased.Power was decreased at 3/5 in both legs.There was bilateral hyperreflexia, and extensor plantars.He had a global loss of sensation to the level of L1. There was also decreased anal tone on digital rectal examination.There was tenderness on palpation of the thoracic and lumbar spine.

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