Abstract | OBJECTIVES: CASE REPORT: A patient was treated with 2 EDBPs for a presumptive cerebrospinal fluid leak 3 weeks after an epidural steroid injection. The second EDBP was performed under direct fluoroscopic guidance, yet resulted in spinal cord compression with radiologic evidence of an epidural hematoma. The patient developed acute cauda equina syndrome and required an emergent decompressive laminectomy resulting in partial resolution of neurological symptoms. One year after the procedure, the patient has recovered most of her motor function but with some persistent numbness below the left knee and a left foot drop. CONCLUSIONS: A cauda equina syndrome from an epidural hematoma may occur as a rare complication of an EDBP, even with direct fluoroscopic guidance. Early diagnosis of symptoms and prompt surgical evacuation of an epidural hematoma is essential and may result in the resolution of symptoms. This complication remains a rare occurrence and should not deter the performance of an EDBP, when indicated.
|
Authors | Sonya P Mehta, Bart P Keogh, Arthur M Lam |
Journal | Regional anesthesia and pain medicine
(Reg Anesth Pain Med)
2014 Jan-Feb
Vol. 39
Issue 1
Pg. 78-80
ISSN: 1532-8651 [Electronic] England |
PMID | 24310044
(Publication Type: Case Reports, Journal Article)
|
Topics |
- Acute Disease
- Adult
- Blood Patch, Epidural
(adverse effects)
- Decompression, Surgical
(methods)
- Female
- Humans
- Laminectomy
(methods)
- Polyradiculopathy
(diagnostic imaging, etiology, surgery)
- Radiography
|