La vena varicosa epidural imita el prolapso de disco y causante de un dolor radicular severo: Reporte de un caso
Epidural varicose vein mimic disc prolapse and causing a severe radicular pain: A case report
Prensa méd. argent; 106 (5), 2020
Publication year: 2020
Venous varicose of epidura is considered a rare cause of nerve root and thecal sac compression and
impingement that leads to lower limb radiculopathy.
The purpose of this study is to draw attention to this problem during operation. It also aims to focus
shed a light on using magnetic resonance imaging (MRI) before the operation. This research also attempts to evaluate the outcome of the surgery.
Symptoms of epidural varicose with radiculopathy are rare and the diagnosis is often inaccurate by
preoperative clinical examination and radiology investigations. Thus, in many cases the diagnosis is
made intra- operatively.
The case was a 40 years old female who consulted our outpatient clinic complaining from acute radicular pain in the lower back and down of her right lower limb. MRI was done for her and showed
paracentral disc herniation. Intra operatively, an abnormal dilatation of epidural vein impingement on
L4 nerve root with no foraminal stenosis was seen. We initiated a thermo coagulation of the epidural
vein from proximal to distal ends at disc level and used gel foam patch to control bleeding that was
removed all at the end of operation. Then, coagulation ablation was performed. The operation resulted
in relief of symptoms and neurologic recovery occurred during follow up period.
According to our case and previously published case reports, the outcome is good with recovery of
neurological signs and symptoms that can be obtained by coagulation ablation of epidural varicose vein.