Cauda equina syndrome post epidural steroid injection

We report a case of a 62-year-old lady who developed cauda equina syndrome post- epidural steroid injection. She undergone an epidural injection to relieve her radiculopathy pain caused by underlying lumbar spinal canal stenosis L4/L5 and L5/S1. Post epidural injection she developed an acute bowel...

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Main Authors:	Ang, Poh Thean, Zakaria@Mohamad, Zamzuri, Karupiah, Rajandra Kumar, Awang, Mohd Shukrimi
Format:	Article
Language:	English
Published:	Juniper Publishers 2018
Subjects:	RD701 Orthopedics
Online Access:	http://irep.iium.edu.my/71075/ http://irep.iium.edu.my/71075/ http://irep.iium.edu.my/71075/1/JOJOOS.MS.ID.555582.pdf

id	iium-71075
recordtype	eprints
spelling	iium-710752019-03-11T07:44:08Z http://irep.iium.edu.my/71075/ Cauda equina syndrome post epidural steroid injection Ang, Poh Thean Zakaria@Mohamad, Zamzuri Karupiah, Rajandra Kumar Awang, Mohd Shukrimi RD701 Orthopedics We report a case of a 62-year-old lady who developed cauda equina syndrome post- epidural steroid injection. She undergone an epidural injection to relieve her radiculopathy pain caused by underlying lumbar spinal canal stenosis L4/L5 and L5/S1. Post epidural injection she developed an acute bowel and bladder dysfunction, worsening pain and weakness over her bilateral lower limbs with saddle anesthesia which did not resolve after 6 days. Her repeated magnetic resonance imaging (MRI) post- epidural injection shows no evidence of extradural hemorrhage/ collection and is unremarkable as compared to her pre- epidural magnetic resonance images. She undergone emergency laminectomy of L4/ L5 and L5/S1. Post laminectomy, her bilateral lower limb pain resolved, power restored, and she regained her bowel and bladder functions. The development of cauda equina syndrome post epidural injection have been reported as a rare complication and is commonly associated with local anesthetic toxicity, direct trauma of the needle to the spinal cord or the development epidural hematoma post injection. However, in this case there was no evidence of epidural hematoma both on magnetic resonance imaging and intraoperatively. Complete neurological recovery occurs following laminectomy suggesting the likely cause of cauda equina syndrome in this case is more to a mechanical compression. Juniper Publishers 2018-12 Article PeerReviewed application/pdf en http://irep.iium.edu.my/71075/1/JOJOOS.MS.ID.555582.pdf Ang, Poh Thean and Zakaria@Mohamad, Zamzuri and Karupiah, Rajandra Kumar and Awang, Mohd Shukrimi (2018) Cauda equina syndrome post epidural steroid injection. Juniper Online Journal of Orthopaedic & Orthoplastic Surgery, 2 (2). 001-005. ISSN 2471-6804 https://www.ncbi.nlm.nih.gov/pubmed/16904497
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	RD701 Orthopedics
spellingShingle	RD701 Orthopedics Ang, Poh Thean Zakaria@Mohamad, Zamzuri Karupiah, Rajandra Kumar Awang, Mohd Shukrimi Cauda equina syndrome post epidural steroid injection
description	We report a case of a 62-year-old lady who developed cauda equina syndrome post- epidural steroid injection. She undergone an epidural injection to relieve her radiculopathy pain caused by underlying lumbar spinal canal stenosis L4/L5 and L5/S1. Post epidural injection she developed an acute bowel and bladder dysfunction, worsening pain and weakness over her bilateral lower limbs with saddle anesthesia which did not resolve after 6 days. Her repeated magnetic resonance imaging (MRI) post- epidural injection shows no evidence of extradural hemorrhage/ collection and is unremarkable as compared to her pre- epidural magnetic resonance images. She undergone emergency laminectomy of L4/ L5 and L5/S1. Post laminectomy, her bilateral lower limb pain resolved, power restored, and she regained her bowel and bladder functions. The development of cauda equina syndrome post epidural injection have been reported as a rare complication and is commonly associated with local anesthetic toxicity, direct trauma of the needle to the spinal cord or the development epidural hematoma post injection. However, in this case there was no evidence of epidural hematoma both on magnetic resonance imaging and intraoperatively. Complete neurological recovery occurs following laminectomy suggesting the likely cause of cauda equina syndrome in this case is more to a mechanical compression.
format	Article
author	Ang, Poh Thean Zakaria@Mohamad, Zamzuri Karupiah, Rajandra Kumar Awang, Mohd Shukrimi
author_facet	Ang, Poh Thean Zakaria@Mohamad, Zamzuri Karupiah, Rajandra Kumar Awang, Mohd Shukrimi
author_sort	Ang, Poh Thean
title	Cauda equina syndrome post epidural steroid injection
title_short	Cauda equina syndrome post epidural steroid injection
title_full	Cauda equina syndrome post epidural steroid injection
title_fullStr	Cauda equina syndrome post epidural steroid injection
title_full_unstemmed	Cauda equina syndrome post epidural steroid injection
title_sort	cauda equina syndrome post epidural steroid injection
publisher	Juniper Publishers
publishDate	2018
url	http://irep.iium.edu.my/71075/ http://irep.iium.edu.my/71075/ http://irep.iium.edu.my/71075/1/JOJOOS.MS.ID.555582.pdf
first_indexed	2023-09-18T21:40:53Z
last_indexed	2023-09-18T21:40:53Z
_version_	1777413131859918848

Cauda equina syndrome post epidural steroid injection

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