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• W2029066182 abstract "Epidural Steroid Injections have been used to manage both low back and leg pain for more than 30 years. Fluoroscopically guided epidural injections carry an overall complication rate of 0% - 9.6%.1 Paraplegia following a transforaminal injection is extremely rare but has been reported as few case reports. 59 y/o F presented with low back and left leg radicular symptoms. Her baseline MRI revealed multilevel spinal stenosis with disc protrusions at L4-5 levels. Patient underwent Left L4 and L5 TFESI. A 22- gauge 5 inch spinal needle was advanced into cephalad aspect of the safe triangle. Needle tip was confirmed and Methyl prednisone acetate with 1% lidocaine was injected as per ISIS guidelines. Patient instantaneously developed ASIA-C T 10 paraplegia. MRI within 24 and 48hrs were negative for any ischemic cord injury or hemorrhage. Patient recuperated most of her neurological deficits on the right side in 48hrs but her recovery pattern on right side remained protracted. She continued to make neurological and functional gains over next 14 days. There are total 12 cases of paraplegia reported in literature following an epidural steroid injection. We hereby report the only case of transient paraplegia which resolved within 15 days. Her recovery pattern precludes a possibility of intrathecal or subdural injection. A plausible explanation ranges from vascular spasm, intravascular injury to a possibility of double crush syndrome where- in her baseline significant spinal pathology predisposed her to develop spinal cord injury following an epidural injection. (1. Houten, J. K., & Errico, T. J. (2002). Paraplegia after lumbosacral nerve root block: Report of three cases. The Spine Journal, 2(1), 70-75.) Epidural Steroid Injections have been used to manage both low back and leg pain for more than 30 years. Fluoroscopically guided epidural injections carry an overall complication rate of 0% - 9.6%.1 Paraplegia following a transforaminal injection is extremely rare but has been reported as few case reports. 59 y/o F presented with low back and left leg radicular symptoms. Her baseline MRI revealed multilevel spinal stenosis with disc protrusions at L4-5 levels. Patient underwent Left L4 and L5 TFESI. A 22- gauge 5 inch spinal needle was advanced into cephalad aspect of the safe triangle. Needle tip was confirmed and Methyl prednisone acetate with 1% lidocaine was injected as per ISIS guidelines. Patient instantaneously developed ASIA-C T 10 paraplegia. MRI within 24 and 48hrs were negative for any ischemic cord injury or hemorrhage. Patient recuperated most of her neurological deficits on the right side in 48hrs but her recovery pattern on right side remained protracted. She continued to make neurological and functional gains over next 14 days. There are total 12 cases of paraplegia reported in literature following an epidural steroid injection. We hereby report the only case of transient paraplegia which resolved within 15 days. Her recovery pattern precludes a possibility of intrathecal or subdural injection. A plausible explanation ranges from vascular spasm, intravascular injury to a possibility of double crush syndrome where- in her baseline significant spinal pathology predisposed her to develop spinal cord injury following an epidural injection. (1. Houten, J. K., & Errico, T. J. (2002). Paraplegia after lumbosacral nerve root block: Report of three cases. The Spine Journal, 2(1), 70-75.)" @default.
• W2029066182 created "2016-06-24" @default.
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• W2029066182 date "2014-04-01" @default.
• W2029066182 modified "2023-09-23" @default.
• W2029066182 title "(494) An unusual case of ASIA C T-10 Paraplegia after Lumbar Transforaminal Epidural Steroid Injection" @default.
• W2029066182 doi "https://doi.org/10.1016/j.jpain.2014.01.405" @default.
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