Abstract：
The authors report their experience with twenty-one consecutive patients who presented with symptoms and imaging characteristics of a herniated lumbar disc; of whom, at the time of surgery had a vascular loop instead. The procedure was performed on 14 women and seven men with a mean age of 39 years. Clinical complaints included lumbar aching with one limb overt radiculopathy in all patients; with additional sphincter dysfunction in two cases. Symptoms had developed within a mean period of three months. In all patients, the disc was exposed through an L5-S1 (n = 10); L4-L5 (n = 5) and L3-L4 (n = 6) open minimal laminotomy. In 16 patients, rather than a herniated disc they had a lumbar epidural varix, while an arterio-venous fistula was found in the remaining five cases. In all cases, the vascular disorder was resected and its subjacent disc was left intact. One patient had a postoperative blood transfusion. While the radiculopathy dysfunction improved in all patients, four patients reported lasting lumbar pain following surgery. The postoperative imaging confirmed the resolution of the vascular anomaly and an intact disc. The mean length of the follow-up period was 47 months. Either epidural varix or arterio-venous fistula in the lumbar area may mimic a herniated disc on imaging studies. With the usual technique they can be operated safely. Resection of the anomaly can be sufficient for alleviating radiculopathy symptoms.
摘要：
作者报告了他们对21例表现为腰椎间盘突出症的症状和影像学特征的连续患者的经验；其中，在手术的时候有一个血管环。该手术对14名女性和7名男性进行，平均年龄为39岁。临床投诉包括所有患者的腰椎疼痛伴一条肢体明显的神经根病；在2例中有额外的括约肌功能障碍。症状在平均三个月内出现。在所有患者中，椎间盘通过L5-S1(n=10);L4-L5(n=5)和L3-L4(n=6)开放最小椎板切开术暴露。在16名患者中，而不是椎间盘突出，他们有腰椎硬膜外静脉曲张，而在其余5例中发现了动静脉瘘。在所有情况下,切除血管疾病，其下方的椎间盘完好无损。一名患者术后输血。虽然神经根病功能障碍在所有患者中都得到了改善，4例患者报告了手术后持续的腰椎疼痛.术后成像证实了血管异常和完整椎间盘的分辨率。平均随访时间为47个月。在影像学研究中，腰椎区域的硬膜外静脉曲张或动静脉瘘都可能模仿椎间盘突出。使用通常的技术，他们可以安全地操作。切除异常足以减轻神经根病的症状。
