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J Bone Joint Surg Br. 2012 Sep;94(9):1292-4. doi: 10.1302/0301-620X.94B9.29322.

Neurogenic claudication without spinal stenosis arising as a result of lumbar epidural varices.

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  • 1Southampton General Hospital, Department of Trauma and Orthopaedics, Tremona Road, Southampton, Hampshire SO16 6YD, UK. hiteshdabasia80@googlemail.com

Abstract

Neurogenic claudication is most frequently observed in patients with degenerative lumbar spinal stenosis. We describe a patient with lumbar epidural varices secondary to obstruction of the inferior vena cava by pathological lymph nodes presenting with this syndrome. Following a diagnosis of follicular lymphoma, successful chemotherapy led to the resolution of the varices and the symptoms of neurogenic claudication. The lumbar epidural venous plexus may have an important role in the pathogenesis of spinal stenosis. Although rare, epidural venous engorgement can induce neurogenic claudication without spinal stenosis. Further investigations should be directed at identifying an underlying cause.

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