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Epidural Injections Contraindicated for Lumbar Radiculopathy in May-Thurner Syndrome: A Case Report
1From the Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
A & a Case Reports
|July 12, 2017
Summary
Worsening May-Thurner Syndrome caused severe back and leg pain due to venous plexus engorgement. Relief required addressing the venous obstruction, not standard pain injections.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- May-Thurner Syndrome (MTS) involves iliac vein compression, typically causing lower extremity swelling.
- Chronic pain presentations can be complex, sometimes stemming from uncommon vascular etiologies.
Observation:
- A 59-year-old patient presented with lumbar back pain, bilateral thigh pain, and radiculopathy.
- Imaging revealed epidural venous plexus engorgement compressing the thecal sac, alongside mild degenerative spinal changes.
Findings:
- The patient's symptoms were attributed to worsening May-Thurner Syndrome, leading to venous plexus engorgement.
- Standard pain management injections were deemed ineffective for this vascular-related condition.
Implications:
- This case highlights the importance of considering vascular causes, like MTS, in refractory chronic pain syndromes.
- Effective management necessitates addressing the underlying venous obstruction, often requiring vascular surgical intervention.
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