Varicosis of the venous epidural plexus caused by portocaval hypertension mimicking symptomatic lumbar disc herniation: case report and review of the literature.

摘要

Intraosseous venous blood drains into the central basiventral vein which connects to the venous plexus in the anterior epi-dural space. Two pathways have been described for the drainage of this venous plexus. The first pathway is along the internal vertebral veins which run cau-dally and cranially in the anterior spinal canal and are interlinked. The second pathway is along the valve-less radicular veins which run laterally to the extraspi-nal compartment and connect directly to the inferior vena cava. An increase of pressure in the inferior vena cava may thus occasionally be transferred into the intraspinal compartment [17]. We report the first case of symptomatic epidural varix formation due to alcohol-associated liver cirrhosis with portocaval hypertension and performed a review of the literature especially addressing the therapeutic options.