tailieunhanh - báo cáo khoa học: "Epidural varicosis as a possible cause of radicular pain: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Epidural varicosis as a possible cause of radicular pain: a case report | Endres Journal of Medical Case Reports 2011 5 537 http content 5 1 537 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Epidural varicosis as a possible cause of radicular pain a case report Stefan Endres Abstract Introduction The incidence rate of epidural varicosis has declined by to since the introduction of computed tomography and magnetic resonance imaging. Despite the use of these modern imaging methods it can still be difficult to distinguish the diagnosis of epidural varicosis from other causes such as nucleus pulposus prolapse. Case presentation We present the case of a 48-year-old Caucasian woman who had been experiencing sciatic pain for seven years. A physical examination showed nerve root pain at L5 on the right side with positive signs of neurotension. During an elective hysterectomy due to endometriosis unusually pronounced varicosis in her lesser pelvis was seen that had not previously been detected. Postoperatively our patient developed a symptomatic pulmonary embolism. Findings from magnetic resonance tomography of her lumbar spine in conjunction with our patient s history were considered by the radiologist to be indicative of epidural varicosis. No further pathological abnormalities that could have been the cause of the nerve root pain were found. Conclusions In cases of epidural varicosis with irritation of neural structures as a result of inferior vena cava hypoplasia surgical treatment leads to unsatisfactory results. Significantly better results can be achieved by resolving the cause of the vena cava pathology. In cases of hypoplasia or aplasia of the inferior vena cava this is not always possible consequently as in the case of our patient only a symptomatic therapy in combination with an anticoagulant and compression therapy can be performed. Introduction Low back pain with unilateral or bilateral radicular pain is mainly caused by protrusions of the intervertebral disc tissue that come into .