Diagnosis and Surgical Treatment of Epidural Varicose Veins of the Lumbar Spine

Kayode Agboola, Eugene Slynko
2021 Acta Scientific Neurology  
Dilated lumbar epidural veins are vascular abnormalities causing compression, ischemic injury and excessive pressure on spinal nerve roots, theca sac or dorsal ganglia, giving rise to symptoms of lumbar radiculopathy of the involved neural structures. Degenerative changes of the spine might also be observed. Importance: The importance of mentioned pathology is in the complexity of its diagnosis -missed diagnosis, relatively small number of observations, classification types, publications and
more » ... publications and estimates of the long-term outcomes of surgical treatment of this pathology on follow-ups. Misdiagnosis is often encountered due to low awareness even on MRI. Objectives: The aim of this study was to increase the awareness and lay emphasis on the importance of diagnosis, classification, pattern of occurrence, and surgical treatment of lumbar epidural varices. Observation: N = 100. Diagnostic Method: Enhanced lumbar MRI and occasional CT. Additional Diagnostic Method: Venospondylography. Surgical Intervention: Laminectomy and microscopic decompression using micro-coagulation -bipolar cautery and eventual excision. Outcomes: 65.0%, 27.0% and 8.0% segmentary, local and diffused varices respectively in two cohort studies. Radicular pain regressed across the spectrum of our observations respectively in accordance to the above classification. Discussion and Conclusion: Occurrence, diagnostic algorithms, clinical classification and surgical treatment of LEV must be assessed, identified and established to optimal algorithm for examining patients with LEV Combining Venospondylography with VAS as a screening method for verification of LEV, we optimised Clinical manifestations, diagnostic criteria and tactics. We Optimised diagnostics tactics, patterns of frequency and eventually maximise surgical tactics in conjunction with adequate verification and established indications for surgical intervention in case of failure of complex conservative treatment for 6 months, or earlier with the progression of neurological symptoms in no less than 6 months. Conclusively, LEV should be considered in the differential diagnosis of spinal radiculopathy.
doi:10.31080/asne.2021.04.0316 fatcat:5tef7jbsubgzph76sa4yqxii3e