Jeon Seok Ho, Jang Won, Kim Sun-Hee, Cho Yong-Hyun, Lee Hyun Seok, Ko Hyun Cheol
Department of Anesthesiology and Pain Medicine, Seoul Sungsim General Hospital, Seoul, Korea.
Anesth Pain Med (Seoul). 2021 Jan;16(1):96-102. doi: 10.17085/apm.20068. Epub 2021 Jan 21.
Transforaminal epidural steroid injection (TFESI) is a conservative treatment for patients with lumbar disc herniation (LDH). However, there are reports of various complications that can occur after TFESI; among these, paraplegia is a serious complication.
A 70-year-old woman who was unable to lie supine due to low back pain exacerbation during back extension underwent TFESI. After injection, there was pain relief and the patient was able to lie supine; however, paraplegia developed immediately. Magnetic resonance imaging confirmed cauda equina syndrome (CES) due to nerve compression from L1-2 LDH. We determined that the patient's LDH was already severe enough to be considered CES and that the TFESI procedure performed without an accurate understanding of the patient's condition aggravated the disease.
It is important to accurately determine the cause of pain and disease state of a patient to establish a correct treatment plan before TFESI is performed.
经椎间孔硬膜外类固醇注射（TFESI）是腰椎间盘突出症（LDH）患者的一种保守治疗方法。然而，有报道称TFESI后可能会出现各种并发症；其中，截瘫是一种严重的并发症。
一名70岁女性，因后伸时腰痛加重而无法仰卧，接受了TFESI治疗。注射后，疼痛缓解，患者能够仰卧；然而，立即出现了截瘫。磁共振成像证实由于L1-2腰椎间盘突出症导致神经受压，出现了马尾神经综合征（CES）。我们确定患者的腰椎间盘突出症已经严重到足以被认为是CES，并且在没有准确了解患者病情的情况下进行的TFESI手术加重了病情。
在进行TFESI之前，准确确定患者的疼痛原因和疾病状态对于制定正确的治疗方案很重要。
