Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
World Neurosurg. 2020 May;137:421-424. doi: 10.1016/j.wneu.2020.02.111. Epub 2020 Feb 27.
An epidural nerve block injection is the most common modality of treatment for control of low backache associated with radiating pain. Epidural catheter injections are also widely used by pain physicians to control cancer pain. Epidural catheters could be associated with procedure-related complications, such as epidural hematoma, epidural abscess, and post-dural puncture headache, and rare complications, such as shearing or breakage of the catheter tip. In this report, we describe the full-endoscopic removal of a sheared epidural catheter fragment.
A man aged 24 years presented with low backache radiating to his left leg with numbness and weakness. Left-sided L4-L5 disc herniation was diagnosed on magnetic resonance imaging, and the patient was posted for an epidural nerve block. The epidural catheter broke during removal, and a 4-cm fragment was retained in the epidural space. We performed an interlaminar full-endoscopic removal of the sheared epidural catheter. Postoperatively, the patient reported excellent clinical outcome.
Interlaminar full-endoscopic procedure could be used for the removal of the retained epidural catheter as a practical option.
硬膜外神经阻滞注射是治疗与放射痛相关的腰痛的最常见方法。疼痛医师也广泛使用硬膜外导管注射来控制癌症疼痛。硬膜外导管可能与与操作相关的并发症有关，如硬膜外血肿、硬膜外脓肿和硬膜后穿刺头痛，以及罕见的并发症，如导管尖端的剪断或断裂。在本报告中，我们描述了经皮内镜下切除剪断的硬膜外导管碎片。
一名 24 岁男性因腰痛放射至左腿出现麻木和无力而就诊。磁共振成像诊断为左侧 L4-L5 椎间盘突出症，患者被安排行硬膜外神经阻滞。硬膜外导管在取出过程中断裂，4 厘米长的碎片残留在硬膜外腔。我们采用经皮内镜下椎板间入路切除剪断的硬膜外导管。术后，患者报告了良好的临床效果。
经皮内镜下手术可作为一种实用的选择，用于取出残留的硬膜外导管。
