May Thurner Syndrome
May-Thurner syndrome or iliac vein compression syndrome is a disease characterized by venous congestion in the left common iliac vein (LCIV) due to right common iliac artery compression.
This syndrome is covered in the vascular literature, it remains absent from the orthopedic and neurosurgery literature and was not been previously reported to occur in concordance with spine surgery.
Case reports
A 53-year-old man gradually developed left sciatica; however, radiological examination showed no causal findings. Conservative medical treatment did not result in satisfactory pain relief. During the follow-up period, edema and brownish skin pigmentation were noted on the left crural region. Follow-up magnetic resonance imaging of lumbar spine revealed vascular enlargement around the spine and compression of the LCIV by the right common iliac artery. Furthermore, the left S1 nerve root was compressed by enlarged veins, which was thought to be the cause of left S1 radiculopathy and SN. After the stenosed part of the LCIV was expanded, the pain and edema in the left leg disappeared.
This is the first report of SN associated with MTS. MTS should be considered as one of the differential diagnoses of SN. Thus, symptoms such as pain, edema, and skin hyperpigmentation on the left leg should be closely noted 1).
2015
A 33-year-old woman was followed postoperatively via clinical and radiographic findings. Her presentation, operative treatment, postoperative extensive deep venous thrombosis (DVT) formation, and management are described. Results We present a unique case of a healthy 33-year-old woman who developed an extensive left iliac vein DVT after anterior lumbar spine fusion. Although she had multiple risk factors for thrombosis, the size of the thrombus was atypical. A subsequent venogram showed compression of the left common iliac vein by the right common iliac artery, consistent with May-Thurner syndrome. Conclusions May-Thurner syndrome or iliac vein compression syndrome is a rare diagnosis that is absent from the spine literature. The condition can predispose patients to extensive iliac vein DVT. The contributing anatomy and subsequent clot often require catheter-directed thrombolysis and stenting to achieve a favorable outcome 2).