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

Background contextLumbar 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.PurposeTo document the first report of thrombolith in the dilated vertebral epidural venous plexus presenting as a lumbar radiculopathy.Study design/settingA case report and literature review.MethodsA 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.ResultsThe 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.ConclusionsA 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.