An unusual complication of sacral nerve root injury following bone marrow harvesting: a case report

Abstract

Background Hematopoietic stem cell transplantation (HSCT) remains an important therapeutic option for many hematologic malignancies. Bone marrow harvesting from an appropriate donor must be conducted for hematopoietic stem cell transplantation (HSCT). Many previous studies show complications of the recipient after hematopoietic stem cell transplantation (HSCT). However, complications of the donor after bone marrow harvesting are rare. We here report a unique case of a patient who developed sacral nerve root injury after bone marrow harvesting. Case presentation A 26-year-old man was admitted to our medical center complaining of acute onset painful burning and tingling sensation at the left posterior thigh and calf. He was a bone marrow donor for his brother’s bone marrow transplantation. He had underwent a bone marrow harvesting procedure two days before admission as a bone marrow donor, using both posterior superior iliac spine (PSIS) as the puncture site. Pelvic magnetic resonance image (MRI) showed enhancement around the left S2 nerve root in T1 and T2-weighted images. Nerve conduction studies (NCS) revealed normal conduction velocity and amplitude on both lower extremities. Electromyography (EMG) presented abnormal spontaneous activity and neurogenic motor unit potentials on the S2-innervated intrinsic foot muscle and gastrocnemius, soleus muscle on the left. The patient was treated with pregabalin for pain control. The patient was followed up after 3, 6, and 12 months. Neuropathic pain improved to Visual Analogue Scale (VAS) 1, and recovery state was confirmed by re-innervation patterns of motor unit potentials in electromyography. Conclusion Bone marrow harvesting is a relatively safe procedure. However, variable complications may occur. Accurate anatomical knowledge and carefulness are required to avoid sacral nerve root injury when performing the bone marrow harvesting procedure.

Lumbosacral plexopathy due to neurolymphomatosis superimposed on traumatic nerve injury

“…However, there have been a few case reports of nerve injury after a bone marrow biopsy. [1][2][3] The current case presented severe pain immediately after a bone marrow biopsy. The initial electrodiagnostic study did not reveal any abnormal spontaneous activity, suggesting that there were no ongoing nerve injuries.…”

Perinatal Tissue-Derived Stem Cells: An Emerging Therapeutic Strategy for Challenging Neurodegenerative Diseases

“…Although BM cell harvesting is considered a safe procedure, it is invasive and requires the need for general anesthesia, with related potential complications and risks [63]. Moreover, other complications may be present including the frequent presence of acute and/or chronic pain at the sites of aspiration, anemia, vasovagal reaction, and infection [64]. To try to overcome these challenges, a device for a rapid, poorly invasive harvest of BM for both autologous and allogeneic use, called "MarrowMiner", has been developed and recently approved by the US Food and Drug Administration [65].…”

Functional, morphological and molecular characteristics in a novel rat model of spinal sacral nerve injury-surgical approach, pathological process and clinical relevance

“…Early and timely release can improve the quality of life and prevent the progression of urinary system damage 7 , 21 . Additionally, sacral canal cysts, lumbosacral region tumors and iatrogenic factors (pelvic surgery) can all cause acute or chronic spinal sacral nerve injury 8 , 22 – 24 . Spinal sacral nerve injury, therefore, is not uncommon.…”