Extradural thoracic spinal lesion presenting as low back and leg pain.

Abstract

Dear Editor: It is important for the pain physician to accurately diagnose spinal pathology that requires urgent surgical intervention. When signs of spinal cord compression occur, prompt diagnosis and surgical decompression are necessary ⇓. Thoracic disk herniations account for approximately 0.25–0.75% of all symptomatic disk herniations, with 70% showing signs of spinal cord compression by the time of diagnosis ⇓. Unfortunately, because thoracic spinal lesions are rare, they can often be misdiagnosed at first ⇓. Extradural spinal lesions such as calcified, herniated disks in the thoracic spine most commonly present as localized pain in the uper back or pain along a dermatomal distribution in the chest or abdominal area ⇓. They can also mimic lesions of the lumbar spine and initially mislead a physician who is attempting to manage the symptoms of lumbar radicular pain. We present a case of a patient who presented with severe low back and bilateral lower extremity radicular pain who was found to have an extradural thoracic spinal lesion causing critical spinal stenosis and was successfully diagnosed and managed. A 38-year-old-female presented to the Emergency Department for an acute exacerbation of her 2-year history of chronic bilateral back and lower extremity pain. In her right …