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Lumbar epidural varix as a cause of radiculopathy
E N Hanley1, B H Howard, C D Brigham
1Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina.
Study Design:
Venous outflow obstruction or congestion has been implicated in the etiology of some lumbar radicular syndromes. Ten cases of epidural varices or variants manifesting themselves as masses within the lumbar spinal canal or adjacent foramina have been seen.
Objectives:
Diagnosis was made by multiplanar cross-sectional magnetic resonance and computed tomography imaging and confirmed in five patients by operative findings. These venous abnormalities differ from cases of arteriovenous malformations described in the literature.
Method:
Surgical treatment consisting of coagulative oblation and/or excision of the lesion was consistently successful in the five patients who underwent operations for recalcitrant symptoms. The other five patients experienced spontaneous resolution of symptoms. Three distinctly different types of these abnormalities have been identified.
Results:
The described entity may account for some previously unexplained or spontaneously resolving cases of lumbar radiculitis.
Conclusions:
Knowledge of the existence of this condition, its possible etiologies, and its imaging characteristics may assist in its recognition and improved management of patients with it.