Severe Low Back Pain and Radiculopathy during Epiduroscopy / 대한마취과학회지

Epiduroscopy is a new method for managing chronic back pain. However there are potential complications such as hemorrhage, infection, neural damage, and increased pain due to increased epidural and intrathecal pressure. A 59-year-old male patient, suffering from lumbar radiculopathy after spine surgery was referred to the pain clinic. To ensure proper deposition of steroids and epidural lysis of adhesions, fibroptically directed epiduroscopy was planned. After positioning the epiduroscopy, 20 ml of normal saline was injected slowly. Immediately after injection, the patient complained of severe back pain and radiating pain to the lower extremities. When the pain was relieved, we restarted a saline injection. However, severe pain ocurred again and was sustained for more than an hour. There was no clinically significant findings on an emergency MRI. The symptoms improved slowly over a period of two hours.

Epidural Lipomatosis Discovered during Managing of Lower Back Pain: A case report / 대한마취과학회지

We experienced a case of lumbar epidural lipomatosis patient who had been treated with several epidural steroid injection for the management of lower back pain. This 67-years-old man, complained of lower back pain and radiating paresthetic pain to the dorsum of left foot. Epidural lipomatosis is a rare condition of focal or multiple deposition of excessive adipose tissue in epidural space. Since excessive deposited adipose tissue compresses the spinal cord or spinal root, patients complaint the atypical low back pain and low extremity radiculopathy which mimics the symptoms of spinal stenosis or herniated nucleus pulposus. In managing of lower back pain patient, especially who had been treated with steroid previously, we should consider that epidural lipomatois would be one of the cause.