Segmental Spinal Myoclonus Complicating Lumbar Transforaminal Epidural Steroid Injection.
Reg Anesth Ache Med. 2018 Feb 16;:
Authors: Wong SSC, Qiu Q, Cheung CW
Summary
OBJECTIVE: Lumbar transforaminal epidural steroid injection is usually used for treating lumbar radicular ache. We report a case of segmental spinal myoclonus that developed throughout lumbar transforaminal epidural injection with native anesthetic and steroid.
CASE REPORT: A 58-year-old lady with failed again surgical procedure syndrome offered with low again and proper L3 and L4 radicular ache. As she had responded nicely beforehand to diagnostic selective nerve root injection with native anesthetic on the proper L3 and L4 ranges, lumbar transforaminal epidural steroid injection on the similar ranges was scheduled. Throughout injection of ropivacaine and triamcinolone on the proper L3-Four intervertebral foramen, she complained of again ache and instantly developed involuntary contraction of her proper hip. The process was terminated. No new neurological deficit was detected when she was examined 15 minutes after the process. There have been no abnormalities from blood exams and magnetic resonance imaging of the decrease thoracic and lumbar backbone. A neurologist subsequently made the medical analysis of segmental spinal myoclonus. The myoclonus improved over 1 month and finally resolved fully.
CONCLUSIONS: Segmental spinal myoclonus is a uncommon complication after lumbar transforaminal epidural steroid and native anesthetic injection. Ache physicians ought to pay attention to this potential complication.
PMID: 29462057 [PubMed – as supplied by publisher]