Spinal Epidural varicosity resembling prolapsed intervertebral disc on MRI: A diagnostic dilemma for lumbar canal stenosis

Abstract

Sciatica is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice. However rare patholo­gies such as epidural varices may mimic them by causing radicular symptoms. In this case report, we present a 20-years-old man with the complaint of low back pain and bilateral sciatica (Lt>Rt) & neurogenic claudication who was operated for right L5–S1 disc herniation. The lesion interpreted as an extruded disc herniation pre­operatively on MRI but was found to be an epidural varix compressing the nerve roots intraoperatively. The varicosity of veins was found in epidural space causing canal stenosis.

Comprehensive insights into lumbar epidural varicose veins: Three clinical cases and surgical strategies

“…The choice of surgical tactics is intricately linked to the specific subtype and its clinical manifestations, with the overarching goal of decompressing nervous structures. [ 18 19 20 21 22 23 ] As we embark on this exploration, it becomes imperative to delve into the pathogenesis and pathophysiology of lumbar epidural varicose veins, necessitating a comprehensive understanding of the topographic and anatomical features of the venous system in this intricate spinal region. Through this series, we aim to contribute to the evolving knowledge base, fostering a more informed and nuanced approach to the diagnosis and treatment of this intriguing medical condition.…”