Persistent cauda equina syndrome after caudal epidural injection under severe spinal stenosis: a case report

Seo, Young Tak; Kong, Hyun Ho; Lee, Goo Joo; Bang, Heui Je

doi:10.2147/jpr.s134636

Cited by 12 publications

(9 citation statements)

References 27 publications

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“…The advantage of ESI is that it is minimally invasive for patients with lumbar pain. Significant complications after ESI are rare but can result from mechanical ischemia, direct needle injury, infection, or injection solution [10]. It is likely the ESI in our patient was associated with the acute pancreatitis.…”

Section: Discussionmentioning

confidence: 83%

Epidural Steroid Injection-Induced Pancreatitis: A Case Report

et al. 2020

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Rare co-existance of disease or pathology Background:Degenerative disc disease of the lumbar spine can be associated with spinal canal and neuroforaminal stenosis, resulting in severe pain. Conservative approaches to treatment are generally recommended initially, especially in the elderly. Epidural corticosteroid injections can provide significant but temporary pain relief and are a commonly performed procedure in pain management. Pancreatitis caused by corticosteroids is unusual and the prognosis typically is good. Case Report:A 73-year-old woman presented with severe intractable back pain 1 week after lumbar epidural steroid injection for symptomatic spinal stenosis. Imaging confirmed severe multi-level degenerative disc disease of the lumbar spine resulting in severe canal and bilateral neuroforaminal stenosis. Because of abdominal pain and nausea, an abdominal CT and labs were performed, revealing evidence of pancreatic inflammation. Conclusions:Lumbar epidural steroid injection may be a risk factor for developing steroid-induced pancreatitis.

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Section: Discussionmentioning

confidence: 83%

Epidural Steroid Injection-Induced Pancreatitis: A Case Report

et al. 2020

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“…6 Lumbar spinal stenosis or lumbar disc disease increase risk of neurological complication following neuraxial anesthesia. 7,11 Our patient did not have any history of back pain, numbness or claudication pathognomonic of lumbar spinal stenosis, 3 no history of neurological disorder or neurotoxic drug intake, we performed caudal epidural block without any difficulty and there were no signs of hematoma and abscess.…”

Section: Discussionmentioning

confidence: 95%

Transient bladder incontinence following ultrasound guided caudal epidural block

Rajasekaran

Bokka

2021

APIC

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Caudal anesthesia is commonly used a regional anesthesia technique for sub-umbilical surgeries in pediatrics and for chronic pain management in adults. Ultrasound guided caudal epidural block improves the success rate with minimizes complications. We report a patient who underwent lateral sphincterotomy under ultrasound guided caudal epidural anesthesia and developed transient urinary incontinence with prolonged perineal sensory loss postoperatively. Key words: Anesthesia, Caudal epidural, Ultrasound. Citation: Preethipriyadharshini R, Vadhanan CP, Bokka N. Transient bladder incontinence following ultrasound guided caudal epidural block. Anaesth. pain intensive care 2021;25(1):102–104; DOI: 10.35975/apic.v25i1.1437 Received: 17 October 2020; Reviewed: 4 November 2020; Accepted: 5 December 2020

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“…2) stated that space-occupied lesion formed by injected fluid would make transient neurologic deficit. Seo et al 7) also reported that neurotoxicity came from local anesthetics could induce CES. The patient was left with a permanent neurological deficit despite of emergent surgical treatment.…”

Section: Discussionmentioning

confidence: 98%

Cauda Equina Syndrome from Subdural Hematoma after Caudal Epidural Injection

Park

Kim

2021

Nerve

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Caudal epidural injection (CEI) is commonly used to manage patients with low back or leg pain, but cauda equine syndrome (CES) rarely results from epidural and/or subdural hematoma occurred after the procedure. A 71-year-old man presented at our outpatient department with voiding difficulty and radiating pain in both legs 8 days ago after CEI. The patient also complained pain and numbness of saddle area, CES. He had taken clopidogrel for 8 years after cardiac stent insertion. Lumbar magnetic resonance imaging (MRI) revealed subdural hematoma at the L5-S1-S2 level. The patient underwent urgent surgical treatment for hematoma evacuation. We finally recognized that subdural hematoma in lumbar MRI was found to subdural-extra arachnoid hematoma as considering intraoperative findings. To the best of our knowledge, few cases of this complication have been reported after CEI. Subdural hematoma often is concomitant with subarachnoid hematoma. Subdural and subarachnoid hematoma is associated with poor clinical outcomes due to severe edema of nerve rootlets. However, no evidence of edema and swelling of nerve rootlets was observed during surgery in our case. As a result, the patient achieved full recovery more than we expected unlike the case of subdural and subarachnoid hematoma.

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Persistent cauda equina syndrome after caudal epidural injection under severe spinal stenosis: a case report

Cited by 12 publications

References 27 publications

Epidural Steroid Injection-Induced Pancreatitis: A Case Report

Epidural Steroid Injection-Induced Pancreatitis: A Case Report

Transient bladder incontinence following ultrasound guided caudal epidural block

Cauda Equina Syndrome from Subdural Hematoma after Caudal Epidural Injection

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