Cauda Equina Syndrome Post Epidural Steroid Injection
| Autor: | Rajandra Kumar Karupiah, Poh Thean Ang, Mohd Shukrimi Awang |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty medicine.diagnostic_test business.industry Epidural steroid injection medicine.medical_treatment Laminectomy Cauda equina syndrome Magnetic resonance imaging Lumbar spinal canal stenosis medicine.disease Spinal cord Surgery medicine.anatomical_structure Epidural hematoma medicine Saddle anesthesia business |
| Zdroj: | Juniper Online Journal of Orthopedic and Orthoplastic Surgery. 2 |
| ISSN: | 2641-8266 |
| Popis: | We report a case of a 62-year-old lady who developed cauda equina syndrome post- epidural steroid injection. She undergone an epidural injection to relieve her radiculopathy pain caused by underlying lumbar spinal canal stenosis L4/L5 and L5/S1. Post epidural injection she developed an acute bowel and bladder dysfunction, worsening pain and weakness over her bilateral lower limbs with saddle anesthesia which did not resolve after 6 days. Her repeated magnetic resonance imaging (MRI) post- epidural injection shows no evidence of extradural hemorrhage/ collection and is unremarkable as compared to her pre- epidural magnetic resonance images. She undergone emergency laminectomy of L4/ L5 and L5/S1. Post laminectomy, her bilateral lower limb pain resolved, power restored, and she regained her bowel and bladder functions. The development of cauda equina syndrome post epidural injection have been reported as a rare complication and is commonly associated with local anesthetic toxicity, direct trauma of the needle to the spinal cord or the development epidural hematoma post injection. However, in this case there was no evidence of epidural hematoma both on magnetic resonance imaging and intraoperatively. Complete neurological recovery occurs following laminectomy suggesting the likely cause of cauda equina syndrome in this case is more to a mechanical compression. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|