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Spinal epidural hematoma occurring at a distance from the transforaminal epidural injection site: A case report
Sang-In Kim1, Dong-Hyun Lee, Sun-Hee Kim
1Department of Anesthesiology and Pain Medicine, Seoul Sacred Heart General Hospital, Seoul, Korea.
Rationale:
Transforaminal epidural steroid injection (TFESI) is a conservative method to treat back pain due to radiculopathy. However, epidural hematoma can occur after the procedure by various mechanisms, which can cause serious complications.
Patient Concerns:
An 82-year-old man with spinal stenosis was treated with TFESI in the right intervertebral foramen at the L2-L3 level. The next morning, he experienced severe back pain and diffuse motor deficit.
Diagnosis:
Emergency magnetic resonance imaging revealed fluid collection in the posterior epidural space at the T11-L1 level with central-canal stenosis.
Interventions:
Emergency hematoma evacuation was performed to remove the epidural hematoma.
Outcomes:
After the surgery, the back pain disappeared.
Lessons:
Epidural hematoma may occur due to causes other than direct needle injury after TFESI. Therefore, careful observation of the patient is necessary after the procedure.
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