Acute Bilateral Leg Edema Provoked by Spinal Stenosis with Complex Regional Pain Syndrome Mechanism: A Case Report

Bilateral leg edema can result from various diseases, including Complex Regional Pain Syndrome provoked by spinal stenosis. This case report presents the resolution of acute bilateral leg edema and CRPS in a patient with spinal stenosis. A 51-year-old female presented with acute bilateral leg edema and chronic lower back pain. Imaging revealed minimal anterolisthesis of the L4-L5 vertebra and signs of degenerative disease and CRPS type II. Following vertebral decompression, posterior instrumentation and fusion, the patient experienced a significant reduction in edema and resumed daily activities within two months. Inflammation and the immune cascade post-spinal stenosis can trigger the proliferation of connective tissue cells and the release of inflammatory cytokines. This process activates nociceptive afferents that produce neuropeptides, resulting in edema and other CRPS symptoms. Multimodal analgesia, physiotherapy education and surgery, including posterior decompression with instrumentation and fusion, are effective treatments for spinal stenosis with acute bilateral leg edema due to CRPS. Keywords: leg, edema, complex regional pain syndromes, spinal stenosis, spondylolisthesis