J Korean Neurosurg Soc.  2016 Jul;59(4):410-413. 10.3340/jkns.2016.59.4.410.

Lumbar Epidural Varix Mimicking Disc Herniation

• Bursalı A
• Akyoldas G
• Guvenal AB
• Yaman O

• KMID: 2315979
• DOI: http://doi.org/10.3340/jkns.2016.59.4.410

Abstract

Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4-5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient's complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method.

Keyword

Epidural; Lumbar; Radiculopathy; Varix; Venous plexus

MeSH Terms

Adult
Decompression
Diagnosis, Differential
Electrocoagulation
Humans
Leg
Methods
Pathology
Postoperative Period
Radiculopathy
Varicose Veins*

Figure

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  Fig. 1 Preoperative T2-axial (A) and T2-sagittal (B) magnetic resonance imaging show hyperintense lesions compressing the right spinal root. The white arrow shows the lesion.

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  Fig. 2 Preoperative T1-axial (A) and T1-sagittal (B) magnetic resonance imaging show hypointense lesions compressing the right spinal root. The white arrow shows the lesion.

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  Fig. 3 In the pathological examination, large and tortuous vessels were seen (H&E, ×200).

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  Fig. 4 Postoperative T2-axial (A) and T2-sagittal (B) magnetic resonance slices show the absence of the lesion.

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