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

Abstract

Introduction & Intraosseous venous blood drains into the central basiventral vein which connects to the venous plexus in the anterior epidural space. Two pathways have been described for the drainage of this venous plexus. The fi rst pathway is along the internal vertebral veins which run caudally 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 extraspinal 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 fi rst 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.