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Association Of Tarlov Cyst With Cauda Equina Syndrome And Spinal Cord Infarction Following Caudal Epidural Block: A Case Report – Spinal Injection

The article discusses a case where a 40-year-old male patient experienced serious complications after receiving a caudal epidural block (CEB) for lower extremity radicular pain. The patient developed spinal cord infarction, cauda equina syndrome, and a sacral level perineural cyst with hemorrhage. The CEB was performed without image guidance, and it is believed that the ruptured perineural cyst may have contributed to the complications. The patient was treated with high doses of steroids and rehabilitation, but unfortunately, did not experience any neurological improvement. The article highlights the importance of performing magnetic resonance imaging, including the sacral area, before performing CEB to identify the presence of a perineural cyst

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most established day surgery unit in London

Published article

RATIONALE: Caudal epidural block (CEB), which injects drugs into the epidural space through a sacral hiatus, is considered a safer alternative to other approaches. Serious complications, such as cauda equina syndrome or spinal cord infarction, have been reported very rarely, but their coexistence after CEB, which may be related to the ruptured perineural cyst, also known as a Tarlov cyst, was not reported.

Spine Epidural Lumbar Caudal transforaminal Expert. Best Spinal Surgeon UK
Abstract Rationale: Caudal epidural block (CEB), which injects drugs into the epidural space through a sacral hiatus, is considered a safer alternative to other approaches. Serious complications, such as cauda equina syndrome or spinal cord infarction, have been reported very rarely, but their coexistence after CEB, which may be related to the ruptured perineural cyst,

Abstract

Rationale: Caudal epidural block (CEB), which injects drugs into the epidural space through a sacral hiatus, is considered a safer alternative to other approaches. Serious complications, such as cauda equina syndrome or spinal cord infarction, have been reported very rarely, but their coexistence after CEB, which may be related to the ruptured perineural cyst, also known as a Tarlov cyst, was not reported.

Patient concerns: A 40-year-old male patient presented with bilateral lower extremity radicular pain. CEB was performed without image guidance. The patient exhibited sensory deficits below L2, no motor function (0-grade), hypotonic deep tendon reflexes, and no pathological reflexes.

Diagnoses: Spinal cord infarction, cauda equina syndrome, and sacral level perineural cyst with hemorrhage.

Intervention: High doses of steroids and rehabilitation were performed.

Outcomes: The patient was discharged after 28 days with persistent bilateral leg paralysis and sensory deficits below the L2 level. The patient demonstrated no neurological improvement.

Lessons: Magnetic resonance imaging, including the sacral area, should be performed before performing CEB, to confirm the presence of a perineural cyst.

The London Spine Unit : most established day surgery unit in London

Read the original publication:

Association of Tarlov cyst with cauda equina syndrome and spinal cord infarction following caudal epidural block: A case report

Doctors Specialising in Cervical Epidural Injection
Mr Purnajyoti Banerjee
Mr. Purnajyoti Banerjee is a consultant in the field of ...

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Abstract Rationale: Caudal epidural block (CEB), which injects drugs into the epidural space through a sacral hiatus, is considered a safer alternative to other approaches. Serious complications, such as cauda equina syndrome or spinal cord infarction, have been reported very rarely, but their coexistence after CEB, which may be related to the ruptured perineural cyst

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