Bursalı Adem, Akyoldas Goktug, Guvenal Ahmet Burak, Yaman Onur
Department of Neurosurgery, Balıkesir State Hospital, Balıkesir, Turkey.
Department of Neurosurgery, Kent Hospital, Izmir, Turkey.
J Korean Neurosurg Soc. 2016 Jul;59(4):410-3. doi: 10.3340/jkns.2016.59.4.410. Epub 2016 Jul 8.
Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4-5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient's complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method.
在神经外科实践中,腰椎神经根病通常由诸如腰椎间盘突出症等公认的病因引起;然而,诸如血栓形成的硬膜外静脉曲张等罕见病理情况可能通过引起神经根症状来模仿这些疾病。在本病例报告中,我们介绍了一名26岁的男性,他因背部和右腿疼痛就诊,接受了右侧L4 - 5椎间盘突出症手术。术前被解释为突出型椎间盘突出症的病变,术中发现是一个压迫神经根的血栓形成的硬膜外静脉曲张。通过双极热凝缩小病变并切除,神经根得以减压。患者的症状在术后消失。血栓形成的腰椎硬膜外静脉曲张在影像学和临床上都可能模仿腰椎间盘突出症。因此,在腰椎间盘突出症的鉴别诊断中必须牢记这一点。显微外科技术是治疗这些疾病的必要手段,热凝和切除减压是一种有效的方法。