Conjoined nerve root, epidural varicose vein, and extruded lumbar disc: Triad of refractory sciatica.

Surgical neurology international Pub Date : 2025-05-23 eCollection Date: 2025-01-01 DOI:10.25259/SNI_371_2025

Nazmin Ahmed, Mohammad Nazrul Hossain, Shahidul Islam Khan, Raad Kazi

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Abstract

Background: A patient presented with sciatica attributed to a conjoined lumbosacral nerve root, an extruded disc herniation, and epidural varicose veins.

Case description: A 60-year-old male presented with 5 months of sciatica (4/5 motor deficit). The lumbosacral magnetic resonance showed a right paracentral disc herniation causing thecal sac/L5-S1 nerve root compression. Intraoperatively, the patient had an L5-S1 conjoined nerve root, an extruded disc herniation, and type C epidural varicose veins. A wide fenestration and foraminotomy were performed to facilitate the removal of the extruded disc and partial coagulation of the epidural varicose veins. Surgery resulted in complete symptom resolution within the 1^st postoperative month.

Conclusion: A patient with intractable right-sided sciatic was found at surgery to have an L5-S1 conjoined nerve root, a herniated disc, and marked epidural varicosities. Following a wide fenestration/foraminal decompression, the patient's symptoms fully resolved within the 1^st postoperative month.

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神经根、硬膜外静脉曲张、腰椎间盘突出：难治性坐骨神经痛三联征。

背景：一个病人表现为坐骨神经痛，原因是腰骶神经根连接、椎间盘突出和硬膜外静脉曲张。病例描述：一名60岁男性，表现为坐骨神经痛5个月（4/5运动障碍）。腰骶部磁共振显示右侧中央旁椎间盘突出，导致鞘囊/L5-S1神经根受压。术中，患者有L5-S1连接神经根，椎间盘突出和C型硬膜外静脉曲张。进行宽开窗和椎间孔切开术，以方便取出突出的椎间盘和部分凝固硬膜外静脉曲张。手术后1个月内症状完全缓解。结论：一例顽固性右侧坐骨神经患者在手术中被发现有L5-S1连接神经根，椎间盘突出，并有明显的硬膜外静脉曲张。在大开窗/椎间孔减压后，患者的症状在术后1个月内完全缓解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Surgical neurology international

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