Radiculopathy Caused by Lumbar Epidural Venous Varices – a Case Report

Authors: M. Cingelová;  E. Pakosová;  M. Lovíšková;  E. Pristašová
Authors‘ workplace: II. Neurologická klinika LF UK a UN Bratislava – Nemocnica akad. L. Dérera
Published in: Cesk Slov Neurol N 2011; 74/107(4): 475-477
Category: Case Report


The authors present a case with a rare pathophysiological element. A patient presented with pain in the lumbar region and radiculopathy. The cause of symptoms was established as vascular malformation arising out of epidural varices. Varices are formed in the epidural location by dilation of the lumbosacral veins. They may form masses that compress neural fibres and imitate spinal stenosis or disc herniation. The pathogenesis of epidural varices is not fully understood. Treatment is by surgery and the prognosis is good.

Key words:
epidural venous varices – vascular malformations – radiculopathy – disc surgery


1. Voháňka S, Mičánková Adamová B. Lumbální spinální stenóza a neurogenní klaudikace. Cesk Slov Neurol N 2009; 72/105(5): 405–417.

2. Cohen I. Extradural varix simulating herniated nucleus pulposis. J Mt Sinai Hosp 1941; 8: 136–138.

3. Epstein BS. Low back pain associated with varices of the epidural vein simulating herniation of the nucleus pulposis. Am J Res 1947; 57: 736–740.

4. Demeulenaere A, Spelle L, Lafitte F, Brunet E, Chiras J. Vertebro-epidural lumbosacral vascular malformations. An unusual cause of lumbo-sciatic pain. J Neuroradiol 1999; 26(4): 225–235.

5. Zimmerman GA, Weingarten K, Lavyne MH. Symptomatic lumbar epidural varices. Report of two cases. J Neurosurg 1994; 80(5): 914–918.

6. Hammer A, Knight I, Agarwal A. Localized venous plexi in the spine simulating prolapse of an intervertebral disc. A report of six cases. Spine 2003; 28(1): E5–E12.

7. Hanley EN jr, Howard BH, Brigham CD, Chapman TM, Guilford WB, Coumas JM. Lumbar epidural varix as a case of radiculopathy. Spine 1994; 19(18): 2112–2126.

8. Ivanovici F. Urine retention: an isolated sign of some spinal cord disorders. J Urol 1970; 104: 284–286.

9. Dickman CA, Zabramski JM, Sonntag VK, Coons S. Myelopathy due to epidural varicose veins of the cer­vicothoracic junction. Case report. J Neurosurg 1988; 69: 940–941.

10. Asamoto S, Sugiyama H, Doi H, Nagao T, Ida M, Matsumoto K. Spinal epidural varices. No Shinkei Geka 1999; 27(10): 911–913.

11. Bammatter S, Schnyder P, De Preux J. CT in thrombosed dilated posterior epidural vein. Eur J Radiol 1987; 7: 116–118.

12. Pekindil G, Yalniz E. Symptomatic lumbar foraminal epidural varix. Case report and review of the literature. Br J Neurosurg 1997; 11(2): 159–160.

13. Albayram S, Wasserman BA, Yousem DM, Wityk R. Intracranial hypotension as a cause of radiculopathy from cervical epidural venous engorgement: case report. AJNR Am J Neuroradiol 2002; 23(4): 618–621.

14. Chun JY, Dillon WP, Berger MS. Symptomatic enlarged cervical anterior epidural venous plexus in patient with Marfan syndrome. AJNR Am J Neuroradiol 2002; 23(4): 622–624.

15. Paksoy Y, Gormus N. Epidural venous plexus enlargements presenting with radiculopathy and back pain in patients with inferior vena cava obstruction or occlusion. Spine 2004; 29(21): 2419–2424.

16. Gormus N, Ustun ME, Paksoy Y, Ogun TC, Solak H. Acute thrombosis of inferior vena cava in a pregnant woman presenting with sciatica: a case report. Ann Vasc Surg 2005; 19(1): 120–122.

17. Hirabayashi Y, Shimizu R, Fukuda H, Saioh K, Igarashi T. Effects of the pregnant uterus on the extradural venous plexus in the supine and lateral position as determined by magnetic resonance imaging. Br J Anaesthesiol 1997; 78(3): 317–319.

18. Kawai M, Udaka F, Nishioka K, Houshimaru M, Koyama T, Kameyama M. A case of idiopathic spinal epidural lipomatosis presented with radicular pain caused by compression with enlarged veins surrounding nerve roots. Acta Neurol Scand 2002; 105(4): 322–325.

19. Moonis G, Hurst RW, Simon SL, Zager EL. Intradural venous varix. A rare cause of an intradural lumbar spine lesion. Spine 2003; 28(20): E430–E432.

20. Wong CH, Thng PL, Thoo FL, Low CO. Symptomatic spinal epidural varices presenting with nerve impingement. Report of two cases and review of the literature. Spine 2003; 28(17): E347–E350.

21. Tofuku K, Koga H, Yone K, Komiya S. Sponta­neous regression of symptomatic lumbar epidural varix. Spine 2007; 32(4): E147–E149.

Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

2011 Issue 4

Most read in this issue

This topic is also in:

Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account