Spinal Arachnoiditis after Continuous Epidural Block

지속적 경막외 차단술 후 발생한 척수거미막염

  • Jang, Hang (Department of Anesthesiology and Neuro-Pain Clinic, Dong Gang Hospital) ;
  • Kim, Jeong-Ho (Department of Anesthesiology and Neuro-Pain Clinic, Dong Gang Hospital) ;
  • Gang, Hoon-Soo (Department of Anesthesiology and Neuro-Pain Clinic, Dong Gang Hospital)
  • 장항 (울산동강병원 마취과) ;
  • 김정호 (울산동강병원 마취과) ;
  • 강훈수 (울산동강병원 마취과)
  • Published : 1997.11.22

Abstract

A 35-year-old female patient was referred to our hospital with neurologic symptoms after continuous epidural block performed 2 days earlier. She die not have any prior no previous lumbar surgery or experience trauma, intraspinal hemorrhage, infections or other known causative factors to associate with neurologic symptoms. Continuous epidural block is widely used for postoperative pain control. Complications can occur with this block including postduralpuncture headache, epidural abscess and rare cases of arachnoiditis etc. We experienced such a case of spinal arachnoiditis after continuous epidural block. Neurologic examination revealed painful bilateral hypoesthesia below $S_2$ level dermatomes, urinary and fecal incontinence and various degrees of leg weakness. The following day, the patient was noted to have bilateral sacral radiculopathies and lesion on proximal portion of both tibial nerve. CSF study reported: protein 264 mg/dl, sugar 64 mg/dl, WBC $7/mm^3$. L-spine MyeloCTscan results were unremarkable. She was discharged after a month of hospitalization and has regular checkups but her neurologic symptoms show no signs of improvement.

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