Key result
Engorged epidural vein mimics lumbar disc herniation by causing L4 nerve root compression and sciatica.
Why the study?
Engorged epidural veins can cause sciatica that mimics lumbar disc herniation, but this etiology is rarely reported.
Case Report (n=1)
An engorged epidural vein can act as a sciatica mimicker, presenting similarly to lumbar disc herniation.
Answers are grounded in this paper and cite their sources.
Raises awareness of sciatica mimickers before lumbar fusion; leaves open whether broader preoperative imaging changes management.
Sciatica is most of the time due to lumbar disc herniation. Some other pathologies such as aneurysmal bone cysts, proximal femur osteomyelitis, arachnoid cysts, facetal cysts, giant cell tumours, and pyriformis syndrome mimic sciatica are termed sciatica mimickers in literature. In this case report, we present a 66-year-old man with low back pain and left sciatica and neurogenic claudication who underwent transforaminal lumbar interbody fusion L4–5. In magnetic resonance imaging, the finding was degenerative changes with foraminal stenosis of L4–L5, but intraoperatively, we found an engorged epidural vein causing the compression of L4 exiting nerve root. The engorged epidural vein sometimes can cause sciatica which mimics the disc herniation.
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Krishnakumar et al. (2024) conducted a case report in Sciatica (n=1). Engorged epidural vein was evaluated on Identification of the cause of nerve root compression. An engorged epidural vein was intraoperatively identified as the cause of L4 nerve root compression and sciatica in a 66-year-old man, mimicking lumbar disc herniation.
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