Post-surgical functional outcomes in patients exhibiting different topographical variants of Lumber epidural varicose veins: a retrospective analysis

Background: Lumbar epidural varicose veins (LEVVs) are an uncommon yet clinically significant cause of lumbar radiculopathy, with an incidence between 0.067% and 1.2%. These venous dilations within the epidural space can compress neural structures, leading to pain and functional impairment. This study aimed to evaluate postoperative functional outcomes in patients with distinct topographical variants of LEVV – diffuse (DVV), local (LVV), and segmental (SVV) – across two time intervals to assess the evolution of clinical management and recovery trends. Methodology: A retrospective analysis was conducted using data from two distinct cohorts: Data Set A (1999–2005, n = 100) and Data Set B (2006–2020, n = 150). All patients had surgically confirmed LEVV and documented preoperative and 6-month postoperative functional assessments. Functional outcomes were measured using the Oswestry Disability Index. Descriptive statistics and inferential analyses (chi-square and paired t -tests) were performed using SPSS version 27, with statistical significance set at P < 0.05. Results: Functional outcomes differed significantly between the two time periods. In Data Set A, the mean disability score was 18%, with no significant association between varicose vein type (VVT) and functionality ( P = 0.979). In contrast, Data Set B demonstrated a higher mean disability score of 41% and a significant association between VVT and functional status ( P = 0.014). Activities most affected by vein type included sitting, sleeping, and sexual life preoperatively, as well as standing and sexual life postoperatively. Conclusion: Diffuse varicose veins were consistently associated with greater postoperative disability compared to local and segmental variants, emphasizing the prognostic relevance of anatomical classification in surgical outcomes. The findings underscore the need for tailored surgical strategies and standardized long-term follow-up to optimize functional recovery in LEVV patients. Further multicentric prospective studies are warranted to validate these observations and refine management protocols.