Low back pain tied to spinal endometriosis

Study design Case report.

We present a case of endometriosis of lumbar vertebrae. The literatures are reviewed with endometriosis of spine. Summary of background data Endometriosis is a common condition, which is defined as endometrial tissue lying outside the endometrial cavity. It is usually found within the peritoneal cavity, predominantly within the pelvis, commonly on the uterosacral ligaments. It can also be found in other sites such as umbilicus, abdominal scars, nasal passages and pleural cavity. But it is very rarely seen in the spine, with no report of endometriosis found in the lumbar vertebrae.

A 33-year-old woman presented with severe low back pain. She had the low back pain periodically for 3 years, and the pain was associated with menstruation. Radiographs showed a lesion in the posterior L3 body. After surgery, tissue biopsy indicated the presence of endometrial tissue in the lesion and thus confirmed endometriosis.

Most cases of spine endometriosis that have been reported are usually found inside spinal canal, endorachis or spinal cord. But spinal vertebrae can also be involved in endometriosis.

Although endometriosis is a rare possible cause of periodical low back pain in women of childbearing age, we suggest that if a woman suffering from periodical low back pain is encountered, do not ignore the possibility of endometriosis in the spine.

Murphy AA (2002) Clinical aspects of endometriosis. Ann N Y Acad Sci 955:1–10 National Institutes of Health (2002) Endometriosis, NIH Publication 02-2413 National Institute of Child Health and Human Development, US Department of Health and Human Services, Rockville, MD Missmer SA, Hankinson SE, Spiegelman D et al (2004) Incidence of laparoscopically confirmed endometriosis by demographic, anthropometric, and lifestyle factors. Am J Epidemiol 160:784–796 Koninckx PR, Meuleman C, Oosterlynck D, Cornillie FJ (1996) Diagnosis of deep endometriosis by clinical examination during menstruation and plasma CA-125 concentration. Fertil Steril 65:280–287 Macek C (1983) Neurological deficits, back pain tied to endometriosis. JAMA 249:686–688 Prendergast SA, Weiss JM (2003) Screening for musculoskeletal causes of pelvic pain. Clin Obstet Gynecol 46:773–782 Battié MC, Cherkin DC, Dunn R et al (1994) Managing low back pain: attitudes and treatment preferences of physical therapists. Phys Ther 74:219–226 Taguchi T (2003) Low back pain in young and middle-aged people. Jpn Med Assoc J 46:417–423 Loney PL, Stratford PW (1999) The prevalence of low back pain in adults: a methodological review of the literature. Phys Ther 79:384–396 Togashi K, Nishimura K, Kimura I, Tsuda Y, Yamashita K, Shibata T et al (1991) Endometrial cysts: diagnosis with MR imaging. Radiology 180:73–78 Balleyguier C, Chapron C, Dubuisson JB, Kinkel K, Fauconnier A, Vieira M et al (2002) Comparison of magnetic resonance imaging and transvaginal ultrasonography in diagnosing bladder endometriosis. J Am Assoc Gynecol Laparosc 9:15–23 Delitto A, Erhand RE, Bowling RW (1995) A treatment-based classification approach to low back syndrome: identifying and staging patients for conservative treatment. Phys Ther 75:470–485 Mounsey AL, Wilgus A, Slawson DC (2006) Diagnosis and management of endometriosis. Am Fam Physician 74(4):594–600 Jackson B, Telner DE (2006) Managing the misplaced: approach to endometriosis. Can Fam Physician 52(11):1420–1424 Richter K (1977) Endometrioid carcinoma of the spinal canal. Geburtshilfe Frauenheilkd 37(9):771–775 Conflict of interest None of the authors has any potential conflict of interest. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Dongxu, Z., Fei, Y., Xing, X. et al. Low back pain tied to spinal endometriosis. Eur Spine J 23 (Suppl 2), 214–217 (2014). https://doi.org/10.1007/s00586-013-2988-x Received: Revised: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00586-013-2988-x