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Case Reports
. 2022 Mar 31:13:125.
doi: 10.25259/SNI_192_2022. eCollection 2022.

Case report: Multiple sclerosis diagnosis after anterior lumbar interbody fusion and presumed COVID-19 infection

Todd H Alter  1 , Thomas Helbig  1 , Gino Chiappetta  1
Affiliations
Case Reports

Case report: Multiple sclerosis diagnosis after anterior lumbar interbody fusion and presumed COVID-19 infection

Todd H Alter et al. Surg Neurol Int. .

Abstract

Background: Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system that may present with a wide variety of clinical presentations. However, there can be substantial overlap between symptoms from MS and those caused by lumbar spondylosis and/or postviral plexopathies.

Case description: A 33-year-old female with a history of an L5-S1 anterior lumbar interbody fusion and exposure to the SARS-CoV-2 virus developed postoperative worsening of her symptoms interpreted as "radiculopathy." Despite a subsequent L5-S1 fusion, she continued to neurologically deteriorate and was ultimately diagnosed with MS.

Conclusion: The initial symptoms/signs of MS may mimic lumbar radiculopathy and or postviral plexopathy (i.e., due to recent COVID-19). This report should serve as a warning to future spinal surgeons to better differentiate between radicular and other "complaints," sufficient to avoid unnecessary repeated spinal surgery.

Keywords: Anterior lumbar interbody fusion; COVID-19; Lumbar; Multiple sclerosis; Myelopathy; Radiculopathy; Spine.

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Conflict of interest statement

There are no conflict of interest.

Figures

Figure 1:
Figure 1:
(a) Anteroposterior radiographs of the lumbar spine. (b) Lateral radiographs of the lumbar spine.
Figure 2:
Figure 2:
(a) Sagittal T2-weighted MRI image of the lumbar spine. (b) Axial T2-weighted MRI image of the lumbar spine.
Figure 3:
Figure 3:
(a) Postoperative anteroposterior radiograph of the lumbar spine demonstrating anteriorly placed interbody cage at the L5-S1 level. (b) Postoperative lateral radiograph of the lumbar spine demonstrating anteriorly placed interbody cage at the L5-S1 level.
Figure 4:
Figure 4:
(a) Sagittal CT image demonstrating alignment of L5-S1 interbody cage. (b) Axial CT image demonstrating alignment of L5-S1 interbody cage.
Figure 5:
Figure 5:
Sagittal T2-weighted MRI image of the lumbar spine.
Figure 6:
Figure 6:
(a) Postoperative anteroposterior radiograph of the lumbar spine demonstrating anteriorly placed interbody cage at the L5-S1 level. (b) Postoperative lateral radiograph of the lumbar spine demonstrating anteriorly placed interbody cage at the L5-S1 level.
See this image and copyright information in PMC

References

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