Left Epidural Space Research Articles

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

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.

Spinal Epidural Teratoma: Review of Spinal Teratoma With Consideration on the Pathogenesis: Case Report

Of the 170 cases of teratomas in the spinal canal reported in the English literature, only 13 were spinal epidural teratomas (SETs). We present a case of SET, review the characteristics of SETs in comparison with spinal intradural teratomas (SITs), and investigate the pathogenesis of spinal teratoma. A 17-month-old boy visited our clinic with paraparesis. A multicystic mass was noted in the left epidural space from T8 to T10 and the left paraspinal area. Complete resection of the tumor, including the paraspinal portion, was accomplished by laminoplastic laminotomy. The tumor was well encapsulated and filled with heterogeneous contents. The tumor was suspected to originate from the left T9 root. On histopathological examination, the tumor was found to be a mature teratoma. The clinical characteristics of SETs and SITs show similarities in age, male preponderance, location, associated anomalies, and pathology. SETs and SITs are probably 2 different types of a single disease entity. Pluripotent somatic cell from the Hensen's node and caudal cell mass is the probable origin of spinal teratoma. However, originating from misplaced primordial germ cell could not be excluded.

A Rare Case of Cavernous Lymphangioma in the Epidural Space of the Cervicothoracic Spine

A case report. To report and discuss a case of lymphangioma in the epidural space of the cervicothoracic spine. Lymphangioma of the soft tissue is not uncommon, but lymphangiomas presenting as a spinal soft tissue tumor in the epidural space are extremely rare. A 61-year-old woman with pain and numbness in the left arm. Magnetic resonance imaging demonstrated a half ring-shaped soft tissue mass in the left epidural space from the C6 to T1 level. The patient underwent osteoplastic laminectomy from C6 to T1. Histopathologic diagnosis of the resected tumor was cavernous lymphangioma. One year after the operation, the patient reported mild pain in left upper limb, but there was no evidence of local recurrence on magnetic resonance imaging. To the authors' knowledge, this is an extremely rare reported case of lymphangioma presenting as a spinal soft tissue tumor in the cervicothoracic epidural space. Further observation is recommended because of the possibility of local recurrence.

Spontaneous Epidural Hematoma at the Lumbar Facet Joint: A Case Report

Spontaneous epidural hematomas (SEHs) of the lumbar spine are rare. The pathogenesis is not entirely clear, but several reports have suggested that bleeding originating in the venous epidural plexus is the cause. This is the second report of a SEH thought to be the result of facet joint hemorrhage with no previous synovial cyst formation. A magnetic resonance image revealed a mass beginning in the left epidural space and continuing through to the left L5-S1 facet joint. Surgically, the epidural hematoma, which was covered by a very thin translucent membrane, was visualized directly. A histopathological examination revealed the wall of the epidural hematoma to be composed of very thin fibrous connective tissue with no synovium lining. The purpose of this study was to report a case of an epidural hematoma originated from lumbar facet joint, diagnosed by radiological examination, and to present a review of the subject literature.

Experience of Right Leg Pain Control by Left Epidural Space Inserted Spinal Cord Stimulator -A case report-

Spinal cord stimulation (SCS) was first attempted by Shearly et al for the relief of intractable pain. A spinal cord stimulator has traditionally been used for failed back surgery syndrome (FBSS) angina pectoris, complex regional pain syndrome (CRPS) and ischemic pain in the extremity. However, the complications associated with the use of a spinal cord stimulator, such as wound infection, hematoma, lead migration and device malfunction; make its long term application difficult. Here, our experience of an interesting case, in which intractable right leg pain was controlled using a spinal cord stimulator placed in the left epidural space, is reported, with a review of the literature.