Iatrogenic CSF Leak from CT Myelogram Leading to Cauda Equina Compression: A Case Report
Martinus Megalla1, Alexander P Decilveo2, Robert M McCunney2
1Department of Orthopaedic Surgery, Hackensack Meridian School of Medicine, Nutley, New Jersey.
Introduction:
Although magnetic resonance imaging (MRI) is the preferred imaging modality for diagnosing cauda equina syndrome (CES), computerized tomography (CT) myelogram may be used in patients who are unable to undergo MRI. When inserting the needle for CT myelogram, there is a risk of cerebrospinal fluid (CSF) leak, which theoretically could lead to CES. To the best of our knowledge, there are no reports of CT myelogram resulting in cauda equina compression.
Case Report:
We report the case of a 38-year-old man who underwent surgical decompression for CES and developed an iatrogenic CSF leak from a pre-operative CT myelogram causing recurrent thecal sac compression requiring repeat surgery and dural repair.
Conclusion:
Although CT myelogram may be used to aid in the diagnosis of CES, consideration should be given to the potential risk for causing a CSF leak and resultant thecal sac compression.
