Case report: Multiple sclerosis diagnosis after anterior lumbar interbody fusion and presumed COVID-19 infection

Surg Neurol Int. 2022 Mar 31:13:125. doi: 10.25259/SNI_192_2022. eCollection 2022.

Abstract

Background: Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system that may present with a wide variety of clinical presentations. However, there can be substantial overlap between symptoms from MS and those caused by lumbar spondylosis and/or postviral plexopathies.

Case description: A 33-year-old female with a history of an L5-S1 anterior lumbar interbody fusion and exposure to the SARS-CoV-2 virus developed postoperative worsening of her symptoms interpreted as "radiculopathy." Despite a subsequent L5-S1 fusion, she continued to neurologically deteriorate and was ultimately diagnosed with MS.

Conclusion: The initial symptoms/signs of MS may mimic lumbar radiculopathy and or postviral plexopathy (i.e., due to recent COVID-19). This report should serve as a warning to future spinal surgeons to better differentiate between radicular and other "complaints," sufficient to avoid unnecessary repeated spinal surgery.

Keywords: Anterior lumbar interbody fusion; COVID-19; Lumbar; Multiple sclerosis; Myelopathy; Radiculopathy; Spine.

Publication types

  • Case Reports