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Post Herpetic Neuropathy of Sinuvertebral Nerve: A Case Report
Seungyoun Kang1, Nitin Maruti Adsul1,2, Hyeun Sung Kim1 , Jongmin Sun1, Sungchan Chung1, Il-Tae Jang1
1Nanoori Gangnam hospital, Seoul, Korea
2Sir Ganga Ram Hospital, New Delhi, India
Correspondence :  Hyeun Sung Kim ,Tel: +82-2-6003-9767, Fax: +82-2-3445-9755, Email: neuros@hanmail.net
Received: September 9, 2018  Revised: October 19, 2018   Accepted: October 29, 2018
Abstract
Background: Varicella-Zoster virus is a neurotropic virus of the herpes virus family that primarily affects sensory nerves. Herpes zoster causing sinuvertebral neuropathy has not been mentioned in the literature. Case Report: A 55 years old man presented with low back pain, both buttocks, posterior thigh and leg pain over last 3 months. A straight leg raising test was positive on both sides. A left great toe dorsiflexion was decreased to 4/5. The VAS score at admission for back and leg pain was 7/10. The patient MRI was showing disc degeneration at L5-S1 level. We performed endoscopic interlaminar annuloplasty using radiofrequency ablation to denervate the sinuvertebral nerve attached to the annulus under epidural anesthesia. Patient symptoms completely relieved at the postoperative period and continued upto recent follow up of 6 months.
Conclusion:
The classical presentation of the patient after herpes zoster infection as back pain with referred leg pain, disc degeneration on MRI, intraoperative evidence of chronic neuropathy and almost complete improvement in patient symptoms after radiofrequency ablation makes it a first reported case of sinuvertebral neuropathy following herpes zoster infection.
KeyWords: Post Herpetic Neuralgia; Sinuvertebral Neuropathy; Radiofrequency Ablation; Lumbar radiculopathy
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