Paraplegia after transforaminal epidural steroid injection in a patient with severe lumbar disc herniation - A case report -

Jeon Seok Ho; Jang Won; Kim Sun-Hee; Cho Yong-Hyun; Lee Hyun Seok; Ko Hyun Cheol

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자료유형: 학술저널

저자정보: Jeon Seok Ho (Seoul Sungsim General Hospital) Jang Won (Seoul Sungsim General Hospital) Kim Sun-Hee (Seoul Sungsim General Hospital) Cho Yong-Hyun (Seoul Sungsim General Hospital) Lee Hyun Seok (Seoul Sungsim General Hospital) Ko Hyun Cheol (Seoul Sungsim General Hospital)

저널정보: 대한마취통증의학회(구 대한마취과학회) Anesthesia and Pain Medicine Anesthesia and Pain Medicine Vol.16 No.1

발행연도: 2021.1

수록면: 96 - 102 (7page)

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Background: Transforaminal epidural steroid injection (TFESI) is a conservative treatment for patients with lumbar disc herniation (LDH). However, there are reports of various complications that can occur after TFESI; among these, paraplegia is a serious complication. Case: A 70-year-old woman who was unable to lie supine due to low back pain exacerbation during back extension underwent TFESI. After injection, there was pain relief and the patient was able to lie supine; however, paraplegia developed immediately. Magnetic resonance imaging confirmed cauda equina syndrome (CES) due to nerve compression from L1–2 LDH. We determined that the patient's LDH was already severe enough to be considered CES and that the TFESI procedure performed without an accurate understanding of the patient's condition aggravated the disease. Conclusions: It is important to accurately determine the cause of pain and disease state of a patient to establish a correct treatment plan before TFESI is performed.

#Cauda equina syndrome #Epidural injection #Intervertebral disc displacement #Paraplegia.

참고문헌 (15)

참고문헌 신청

Zhong M / 2017 / Incidence of spontaneous resorption of lumbar disc herniation : a meta-analysis / Pain Physician 20:E45~52

Andersson GB / 1996 / Consensus summary of the diagnosis and treatment of lumbar disc herniation / Spine (Phila Pa 1976) 21(24 Suppl):75S~78S

Vad VB / 2002 / Transforaminal epidural steroid injections in lumbosacral radiculopathy : a prospective randomized study / Spine (Phila Pa 1976) 27:11~16

Boswell MV / 2005 / Interventional techniques in the management of chronic spinal pain : evidence-based practice guidelines / Pain Physician 8:1~47

Kennedy DJ / 2009 / Paraplegia following image-guided transforaminal lumbar spine epidural steroid injection : two case reports / Pain Med 10:1389~1394

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