A rare calcified thrombosis of the dilated epidural venous plexus presenting with lumbar radiculopathy: a case report

Abstract

Background context: Lumbar radiculopathies may occur in the course of many diseases but are rarely caused by abnormalities or pathologic changes in the epidural venous plexus. We describe a patient with lumbar radiculopathy attributable to a thrombolith of the epidural venous plexus, as diagnosed by computed tomography (CT) and magnetic resonance imaging (MRI), and who was treated by hemilaminectomy and removal of the thrombolith.

Purpose: To document the first report of thrombolith in the dilated vertebral epidural venous plexus presenting as a lumbar radiculopathy.

Study design/setting: A case report and literature review.

Methods: A 72-year-old woman presented with a 2-year history of back pain radiating to the left buttock without a history of any trauma. Lumbar spinal CT and MRI showed a calcified lesion in the left epidural space at the L1 level.

Results: The patient was treated by hemilaminectomy at the T12-L1 level and left epidural mass excision. Histopathology confirmed a thrombolith in the left epidural malformed venous plexus.

Conclusions: A thrombolith causing a lumbar radiculopathy in the dilated epidural venous plexus is a rare condition. If CT or MRI shows a vertebral epidural calcified lesion, an epidural venous thrombolith may be included in the differential diagnosis.