Cauda Equina Syndrome Following Volumetric Caudal Epidural Steroid Injection in a Herniated Interverterbral Disc Patient: A case report / 대한마취과학회지

Volumetric caudal epidural injections of steroid have recently been done in patients with acute or chronic lumbago and sciatica. This method is easier way of sending steroid to the sacral nerve root than lumbar epidural injections. The Cauda equina syndrome is a rare complication of epidural pain block. We report on a case in which an emergency laminectomy was done because cauda equina syndrome occurred just after a volumetric caudal epidural steroid injection in a patient with a herniated interverterbral disc.

Cauda Equina Syndrome Following Epidural Anesthesia: A case report / 대한마취과학회지

Severe neurologic complication after epidural anesthesia is very rare. We experinced a case of cauda equina syndrome following epidural anesthesia with 2% lidocaine 20 ml, alkalinized with sodium bicarbonate and 1: 200,000 epinephrine added in female patient underwent abdominal hysterectomy. She complained hypoesthesia of buttock, perineum, left leg and weakness of left leg. She also suffered from urinary retension and defecation difficulty and abdominal discomfort 2 days after epidural block. In MRI taken 4 days after block, spinal stenosis (L4-5) and mild disc bulging (L3-4) were noted. She was treated with medication, bladder training and physical therapy and recovered slowly but gradually, finally discharged 2 months after block with mild weakeness of left leg. We suggest the causative factors are the temporary neural compression due to spinal stenosis and the spinal cord ischemia due to vascular spasm because of added epinephrine.