Kaya Arzu, Ozgocmen Salih
Department of Physical Medicine and Rehabilitation, Firat University Faculty of Medicine, 23119 Elazig Turkey.
Cases J. 2009 Aug 5;2:6228. doi: 10.4076/1757-1626-2-6228.
Neurological deficits following epidural or spinal anesthesia are extremely rare. Transient paraplegia following epidural anesthesia in a patient with thoracic disc herniation has been presented. A 44-year-old woman developed paraplegia during the operation for vascular surgery of her legs under epidural anesthesia. Epidural hematoma or spinal cord ischemia was ruled out by magnetic resonance imaging of the thoracic and lumbar spine in which protruded disc at T11-12 level compressing the spinal cord has been verified. Patient responded well to steroid treatment and rehabilitation interventions. Physicians should be aware of preceding disc protrusions, which may have detrimental effects on spinal cord perfusion, as a cause of persistent or transient paraplegia before epidural anesthesia procedure. MRI is a valuable imaging option to rule out epidural anesthesia complications and coexisting pathologies like disc herniations.
硬膜外麻醉或脊髓麻醉后出现神经功能缺损极为罕见。本文报告了一例胸椎间盘突出症患者在硬膜外麻醉后发生短暂性截瘫的病例。一名44岁女性在硬膜外麻醉下行腿部血管手术时发生截瘫。胸腰椎磁共振成像排除了硬膜外血肿或脊髓缺血，证实T11-12水平椎间盘突出压迫脊髓。患者对类固醇治疗和康复干预反应良好。医生应意识到先前存在的椎间盘突出可能对脊髓灌注产生不利影响，这是硬膜外麻醉术前持续性或短暂性截瘫的一个原因。磁共振成像对于排除硬膜外麻醉并发症以及椎间盘突出等并存病变是一种有价值的影像学检查方法。
