Radiculopathy caused by lumbar epidural varix

Background Lumbar epidural varix (LEV) is a very rare condition caused by dilatation of the vertebral venous plexus. LEV can result in lumbosacral radiculopathy, which is often mistaken for lumbosacral herniated intervertebral disc (HIVD). Case Report A 72-year-old man visited the emergency department (ED) with radiating pain of the right leg that had developed 3 weeks previously. Before the ED visit, he was diagnosed with lumbosacral radiculopathy due to HIVD based on lumbar X-rays at an outpatient clinic. Despite conservative treatment, his symptoms deteriorated. On magnetic resonance imaging at the ED, an epidural cystic mass in the right L5–S1 with multiple HIVDs was observed. The mass was surgically removed, and the histological findings showed a dilated vessel with a thrombus, which led to the final diagnosis of LEV. Conclusion In lumbosacral radiculopathy, LEV should be considered as a possibility even if degenerative spine disease is observed on lumbar X-rays.