ABSTRACT
A 59-year-old patient presented to the chronic pain clinic with a 6-week history of worsening lumbar back pain, bilateral thigh pain, and unilateral radiculopathy. Magnetic resonance imaging revealed mild discogenic and facetogenic disease, but significant epidural venous plexus engorgement compressing the thecal sac. The patient reported previous treatment by a vascular surgeon for May-Thurner Syndrome, a type of inferior vena caval obstruction, yet had not experienced these specific complaints. A discussion with the radiologist confirmed worsening of the patient's May-Thurner Syndrome was the likely cause of the patient's symptoms. The patient was referred back to the surgeon to relieve the venous obstruction because routine injection therapy would be ineffective.
Subject(s)
Injections, Epidural/adverse effects , Low Back Pain/drug therapy , May-Thurner Syndrome/complications , Humans , Intervertebral Disc/diagnostic imaging , Low Back Pain/etiology , Male , Middle Aged , Radiculopathy/etiologyABSTRACT
OBJECTIVE: To understand an unusual complication of a common procedure. DESIGN: This article chronicles the side effect of a lumbar sympathetic nerve block (LSNB). SETTING: Loyola University Medical Center Outpatient Chronic Pain Clinic. PATIENTS: One. RESULTS: Our patient had several hours of priapism following a LSNB. CONCLUSIONS: A bilateral lumbar sympathetic nerve block can lead to unopposed parasympathetic penile stimulation and cause priapism.
