Spontaneous Regression of Symptomatic Lumbar Epidural Varix

Abstract

A case report of spontaneous regression of symptomatic lumbar epidural varix. To present a case of spontaneous regression of lumbar epidural varix itself and to briefly review the literature. It has previously been reported that some cases of lumbar epidural varix exhibit complete resolution of symptoms without surgery. However, the natural history of lumbar epidural varix is still unclear. To our knowledge, spontaneous regression of lumbar epidural varix itself has not been previously reported in the literature. A 57-year-old woman experienced a sudden episode of low back pain radiating to the right lower extremity during physical exercise. Magnetic resonance imaging revealed a mass lesion in the ventral right epidural space, extending from the L2-L3 intervertebral disc space inferiorly, along the posterior aspect of the L3 vertebral body, to the L3-L4 intervertebral disc space, which was isointense on T1-weighted images and hyperintense on T2-weighted images compared with the L2-L3 disc. Repeat magnetic resonance imaging every 2 weeks revealed that the patient's lumbar epidural varix spontaneously regressed with corresponding changes in clinical symptoms, that it extended from the epidural venous plexus, consistent with epidural varix, and that it exhibited a gradual decrease in size. Although surgical treatment is often performed for symptomatic lumbar epidural varices, the findings of the present case suggest the usefulness of conservative treatment of these lesions in selected patients without major neurologic deficits.