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CASE REPORT
Year : 2016  |  Volume : 50  |  Issue : 4  |  Page : 440-443

Lumbar epidural varices: An unusual cause of lumbar claudication


Department of Spine Surgery, Sethu Sarada Hospital, Madurai, Tamil Nadu, India

Correspondence Address:
Meenakshisundaram Subbiah
Sethu Sarada Hospital, No. 409, Church Road, Anna Nagar, Madurai - 625 020, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5413.185613

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Lumbar epidural varices can also present with radiculopathy similar to acute intervertebral disc prolapse (IVDP). However as the magnetic resonance imaging (MRI) in these patients are usually normal without significant compressive lesions of the nerve roots, the diagnosis is commonly missed or delayed leading to persistent symptoms. We present a rare case of acute severe unilateral claudication with a normal MRI unresponsive to conservative management who was treated surgically. The nerve root on the symptomatic side was found to be compressed by large anterior epidural varices secondary to an abnormal cranial attachment of ligamentum flavum. Decompression of the root and coagulation of the varices resulted in complete pain relief. To conclude, lumbar epidural varices should be considered in the differential diagnosis of acute onset radiculopathy and claudication in the absence of significant MRI findings.


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