A Rare Calcified Complication of Epidural Injections for Lumbar Spinal Stenosis: A Case Presentation and Literature
Carl-Elie Majdalani1, Christopher Mares1, Daniel Shedid2
1Division of Physical Medicine and Rehabilitation, University of Montréal, Centre Hospitalier de l'Université de Montreal, Montreal, QC, Canada.
Background:
Neurogenic claudication secondary to degenerative lumbar stenosis is typically managed with nonsurgical options, such as epidural corticosteroid injections. As a standard and effective treatment for lumbar stenosis, clinicians must be aware of the corticosteroids choice when injecting in the epidural space.
Case Report:
A 62-year-old man presenting with sciatic pain is treated with multiple neuroforaminal, facet, and caudal corticoid injections over the course of several months without any symptomatic resolution. A magnetic resonance imaging of his lumbar spine revealed focal bilateral central stenosis at the L4-L5 level. A computed tomography revealed hyperdense lesions at that level. The patient was referred for a surgical option. He underwent complete minimally invasive resection of the bilateral lesion with instrumented and interbody fusion. The final pathology report identified the mass as a calcified granuloma.
Conclusions:
Following repetitive methylprednisolone acetate injections, one must be aware of all the potential complications arising from particulate corticosteroids.
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