Paraplegia After Thoracic Epidural Steroid Injection

Area of Science:

• Pain Medicine
• Neurology
• Anesthesiology

Background:

• Epidural steroid injections are frequently performed by pain physicians.
• Recent guidelines address performing these injections in patients on anticoagulants.

Observation:

• A patient developed an epidural hematoma and paraplegia.
• This occurred despite strict adherence to current guidelines.

Findings:

• Devastating neurologic complications, such as spinal epidural hematoma, can occur.
• Adherence to guidelines does not eliminate all risks.

Implications:

• Current guidelines may not fully mitigate the risk of severe neurological injury.
• Further research or guideline refinement may be necessary to improve patient safety.