Severe Low Back Pain and Radiculopathy during Epiduroscopy / 대한마취과학회지

ABSTRACT

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.