Paraplegia associated with combined spinal‐epidural anaesthesia caused by preoperatively unrecognized spinal vertebral metastasis

Abstract

We describe a case of paraplegia following combined spinal-epidural anaesthesia. It was postoperatively determined that a tumour of the vertebrae which was compressing the spinal cord was responsible for this complication. We suggest that the pre-existing pathology of the spine must be borne in mind as a differential diagnosis of acute postoperative paraplegia.

Spinal coning after lumbar puncture in a patient with undiagnosed giant cervical neurofibroma

“…Most of the reports[3456789] in literature are descriptions of inadvertent complications encountered during spinal anesthesia (either via lumbar puncture or epidural block) for some non-spinal surgery or myelography [Table 1]. In our case, however, lumbar puncture had been done as a diagnostic tool.…”

“…The vast majority of lesions were found to be metastatic extradural lesions,[3456] but benign extradural pathologies like cervical disc prolapse and tuberculosis also find mention. [78] Less frequently described are intradural extramedullary tumors like the present case.…”

Acute paraplegia after myelography: decompensation of a herniatad thoracic disc

“…An asymptomatic interval up to 10 days has been described. 1 If symptoms are clinically assignable to the level of the procedure, immediate imaging, preferably by MRI, is the diagnostic tool of choice. In urgent cases with severe deficits, direct re-exploration of the operated site without imaging may exceptionally be indicated.…”

Paraplegia following epidural analgesia: A potentially avoidable cause?

“…reported a case of post-operative paraplegia in a previously undiagnosed case of vertebral metastases originating from an endometrial cancer following administration of combined spinal-epidural anesthesia. [11] Graham et al . described a case of paraplegia following spinal anesthesia for bilateral orchidectomy in a case of prostatic carcinoma with spinal metastasis with no pre-existing neurological deficit.…”