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Related Concept Videos

Structural Joints: Cartilaginous Joints01:17

Structural Joints: Cartilaginous Joints

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As the name indicates, at a cartilaginous joint, the adjacent bones are united by cartilage, a tough but flexible type of connective tissue. Unlike synovial joints, these types of joints lack a joint cavity and involve bones joined together by either hyaline cartilage or fibrocartilage.
There are two types of cartilaginous joints:
Synchondrosis
A synchondrosis ("joined by cartilage") is a cartilaginous joint where bones are connected by hyaline cartilage. Synchondrosis may be temporary...
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The back muscles that lie deep into the thoracolumbar fascia are called intrinsic or true back muscles. These muscles are divided into four layers: superficial, intermediate, deep, and deepest layers.
Superficial Layer:
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General Structure of a Vertebra01:30

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A typical vertebra, with the exception of the sacrum and coccyx, consists of a body, a vertebral arch, and seven different projections termed processes. The anterior portion of the vertebrae, the body, supports about half the body’s weight. The vertebral bodies progressively increase in size and thickness from the cervical region to the lumbar region of the vertebral column. The intervertebral discs present between the bodies of adjacent vertebrae firmly unites them, forming a continuous...
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Related Experiment Video

Updated: Jun 17, 2025

Ovine Lumbar Intervertebral Disc Degeneration Model Utilizing a Lateral Retroperitoneal Drill Bit Injury
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Vascular loops mimicking herniated lumbar discs: fair warning.

Marcelo Galarza1,2, Roberto Gazzeri3, Yamila Basilotta4

  • 1School of Medicine, Regional Service of Neurosurgery, "Virgen de La Arrixaca" University Hospital, Universidad de Murcia, El Palmar, 30120, Murcia, Spain. m.galarza@um.es.

Neurosurgical Review
|August 14, 2024
PubMed
Summary

Vascular anomalies in the lumbar spine can mimic herniated discs, leading to misdiagnosis. Surgical resection of these vascular loops, epidural varices, or arteriovenous fistulas effectively resolves radiculopathy symptoms.

Keywords:
Arterio-venous fistulaDiscectomyEpidural lumbarEpidural varixHerniated discMicrosurgical

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Area of Science:

  • Neurosurgery
  • Vascular Surgery
  • Spinal Surgery

Background:

  • Lumbar disc herniation is a common cause of radiculopathy.
  • Vascular anomalies in the lumbar epidural space can present with similar symptoms and imaging findings.
  • Accurate diagnosis is crucial for effective treatment.

Purpose of the Study:

  • To report the surgical experience with patients initially diagnosed with lumbar disc herniation but found to have vascular anomalies.
  • To evaluate the efficacy of surgical resection for these vascular anomalies.
  • To highlight the diagnostic challenges and successful management of these rare conditions.

Main Methods:

  • Retrospective review of 21 consecutive patients undergoing surgery for suspected lumbar disc herniation.
  • Patients were surgically treated via open minimal laminotomy at L5-S1, L4-L5, or L3-L4 levels.
  • Intraoperative findings revealed lumbar epidural varices or arteriovenous fistulas, which were then resected.

Main Results:

  • Twenty-one patients (14 women, 7 men; mean age 39) presented with lumbar pain and radiculopathy.
  • Surgery revealed lumbar epidural varices (16 patients) or arteriovenous fistulas (5 patients) instead of disc herniation.
  • All patients experienced improvement in radiculopathy; 4 reported persistent lumbar pain. Mean follow-up was 47 months.

Conclusions:

  • Lumbar epidural varices and arteriovenous fistulas can mimic herniated discs on imaging.
  • Surgical resection of these vascular anomalies is a safe and effective treatment for associated radiculopathy.
  • Careful surgical technique allows for safe resection while preserving the subjacent disc.