Severe lumbar radiculopathy with epidural venous plexus engorgement in a morbidly obese pediatric patient: A case report

Hee Joon Jeong, Woo Seog Sim, Hue Jung Park, Seung Hwan Lee, Min Seok Oh, Min Kyoung Cho, Heui Jin Seon, Jin Young Lee

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Introduction:Engorgement of the epidural venous plexus (EVP) is a rare cause of nerve root impingement. Dilated epidural veins cause compression of the thecal sac and spinal nerve roots, leading to lumbar radiculopathy.Patient concerns:Here we describe a case of severe lumbar radiculopathy in a 15-year-old morbidly obese boy.Diagnosis:Enhanced lumbar magnetic resonance imaging revealed left sided L1-L2 disc protrusion and engorgement of the lumbar EVP, resulting in narrowing of the thecal sac in the entire lumbar spine. There was no evidence of an intra-abdominal mass, thrombosis of the inferior vena cava, or vascular malformation.Interventions:A caudal epidural block was administered under fluoroscopic guidance. The patient reported a 30% reduction in pain intensity for just 1 day.Outcomes:The patient has been followed up for 2 years. He continues to take medication, including morphine sulfate 15 mg, gabapentin 300 mg, and oxycodone 20 mg per day. He is on a diet with exercise for weight reduction.Conclusion:An engorged EVP should be considered in the differential diagnosis of radiculopathy in morbidly obese patients.

Original languageEnglish
Article numbere16842
JournalMedicine (United States)
Volume98
Issue number33
DOIs
StatePublished - 1 Aug 2019

Bibliographical note

Publisher Copyright:
© 2019 the Author(s).

Keywords

  • engorgement
  • epidural venous plexus
  • lumbar radiculopathy

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