Unexpected Paraplegia after Epidural Steroid Injection Revealing Thoracic Ligamentum Flavum Hypertrophy : Two Case Reports
경막외스테로이드주사 후 발생한 예기치 않은 하지마비 : 흉추 황색인대 비후가 진단된 2예 - 흉추 황색인대 비후로 인한 하지마비 증례
Hyunji Oh, Minjoo Kim, Seunghyuk Ko, Aram Doo, Yeon-Dong Kim
언어
한국어(KOR)
URL
https://www.earticle.net/Article/A480246
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초록
영어
Epidural steroid injection (ESI) is one of the most common interventional procedures for the management of lumbar radicular or axial pain. Although generally safe, rare but devastating complications such as paraplegia can occur. We present two cases of irreversible lower extremity paralysis after ESI, in which previously unrecognized thoracic ligamentum flavum hypertrophy was identified as the underlying cause. Both patients developed acute motor weakness within hours after the procedure—one after interlaminar and the other after caudal ESI. Subsequent MRI revealed severe thoracic spinal cord compression caused by ligamentum flavum hypertrophy at T10–T12. Despite emergent decompressive laminectomy, both patients had persistent neurological deficits. These cases highlight that preexisting thoracic spinal pathology, such as ligamentum flavum hypertrophy, may predispose patients to irreversible spinal cord injury following ESI. Preprocedural neurological assessment and consideration of thoracic imaging in selected high-risk patients may help prevent such catastrophic outcomes.
Hyunji Oh [ 오현지 | Department of Anesthesiology and Pain Medicine, Jeonbuk National University Hospital , Jeonju, Korea ]
Minjoo Kim [ 김민주 | Department of Anesthesiology and Pain Medicine, Jeonbuk National University Hospital , Jeonju, Korea ]
Seunghyuk Ko [ 고승혁 | Department of Anesthesiology and Pain Medicine, Jeonbuk National University Hospital , Jeonju, Korea ]
Aram Doo [ 두아람 | Department of Anesthesiology and Pain Medicine, Jeonbuk National University Hospital/Department of Anesthesiology and Pain Medicine, Jeonbuk National University Medical School, Jeonju, Korea ]
Yeon-Dong Kim [ 김연동 | Department of Anesthesiology and Pain Medicine, Jeonbuk National University Hospital/Department of Anesthesiology and Pain Medicine, Jeonbuk National University Medical School, Jeonju, Korea ]
Corresponding Author