Ammirati Mario, Perino Florence
Department of Neurological Surgery, The Ohio State University, Columbus, Ohio 43210, USA.
J Neurosurg Spine. 2006 Oct;5(4):359-61. doi: 10.3171/spi.2006.5.4.359.
The authors report the first case involving trapped epidural air in the spine that mimicked a mass lesion and caused neurological symptoms after epidural corticosteroid injection in the lumbar region. New neurological symptoms developed immediately after injection, and magnetic resonance (MR) imaging demonstrated trapped air displacing the dural sac. After the patient underwent conservative treatment, the new symptoms resolved, and follow-up MR imaging and computed tomography demonstrated resorption of the epidural air in the lumbar region. To limit this problem, the clinician should decrease the amount of air injected in the epidural space or substitute nitrous oxide for air when injecting steroid agents epidurally.
作者报告了首例腰椎硬膜外注射皮质类固醇后发生的脊髓硬膜外积气病例,该积气模拟占位性病变并导致神经症状。注射后立即出现新的神经症状,磁共振成像显示积气压迫硬膜囊。患者接受保守治疗后,新症状消失,随访磁共振成像和计算机断层扫描显示腰椎硬膜外积气吸收。为避免出现此问题,临床医生在硬膜外注射类固醇药物时应减少注入硬膜外腔的空气量,或用一氧化二氮替代空气。