Letter to the Editor

Ephaptic Transmission as an Explanatory Mechanism of Radicular Pain

Authors: Theofilos Machinis, MD, Kostas N. Fountas, MD, PHD

Abstract

Lower back pain with radicular symptomatology is a common clinical entity that affects hundreds of thousands of people every year. In the vast majority of these cases, disk herniation is evident on the patients’ radiologic evaluation. However, as occasionally encountered in our institution, a fraction of these patients harbor disk prolapse which is minimal or moderate, but definitely disproportionate to their symptomatology. A common intraoperative finding in this group of patients is an enlarged and rich epidural venous network, sometimes with compression of the exiting nerve root caused by the enlarged epidural veins.

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References

1. Seltzerz DM. Ephaptic transmission in chronically damaged peripheral nerves. Neurology1979;29:1061–1064.
 
2. Tomasulo RA. Aberrant conduction in human peripheral nerve: Ephaptic transmission? Neurology1982;32:712–719.
 
3. Paksoy Y, Gormus N. Epidural venous plexus enlargements presenting with radiculopathy and back pain in patients with inferior vena cava obstruction or occlusion. Spine 2004;29:2419–2424.
 
4. LaBan MM, Ay-Ming W, Shetty A, et al. Varicosities of the paravertebral plexus of veins associated with nocturnal spinal pain as imaged by MR venography. Am J Phys Med Rehabil 1999;78:72–76.
 
5. Hammer A, Knight I, Agarwal A. Localized venous plexi in the spine simulating prolapse of an intervertebral disc: a report of six cases. Spine 2003;28:E5–E12.