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Vascular causes of radiculopathy: a literature review.
MedLine Citation:
PMID:  21168101     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND CONTEXT: Vascular etiologies are a significant source of radiculopathy. The entities that are reviewed here include epidural spinal hematoma, subdural spinal hematoma, spinal arteriovenous malformation, vertebral hemangioma, spinal epidural cavernous hemangioma, vertebral artery anomalies (both tortuosity and dissection), aortic aneurysm, hemorrhagic synovial cysts, ligamentum flavum hematoma, and venous varices. The incidence, pathophysiology, typical clinical presentation, appropriate diagnostic workup, and management are summarized.
PURPOSE: To review and summarize various vascular causes of radiculopathy and how it impacts the management of patients with radicular spinal pain.
STUDY DESIGN: Literature review.
METHODS: An extensive literature review was done on each of the vascular entities and their presentation as radiculopathy.
RESULTS: Vascular etiologies of radiculopathy may be underestimated in the literature. Imaging in addition to the history and physical examination is essential to identifying vascular sources of radiculopathy and establishing correct treatment.
CONCLUSIONS: In examining patients with radicular pain, extraspinal causes of radiculopathy including vascular entities should be included in the differential. Knowledge of the incidence, pathophysiology, clinical presentation, and management of the possibly underreported various vascular causes of radiculopathy increase the ability of the physician to provide optimal care for the patient. A key aspect to identifying such vascular lesions is appropriate imaging for documenting the source of radiculopathy. Blind injections, done without appropriate imaging for identifying the cause of radiculopathy, and also performed without fluoroscopic guidance, increase not only the risk of misdiagnosis but also the comorbidities associated with spinal injections.
Authors:
Benoy V Benny; Ameet S Nagpal; Paul Singh; Matthew Smuck
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The spine journal : official journal of the North American Spine Society     Volume:  11     ISSN:  1878-1632     ISO Abbreviation:  Spine J     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101130732     Medline TA:  Spine J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  73-85     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Physical Medicine & Rehabilitation Alliance Program, Baylor College of Medicine & University of Texas Health Science Center, 1709 Dryden Road, Houston, TX 77030, USA. bbenny@bcm.edu
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