• Medicine · Jul 2019

    Case Reports

    Spinal epidural hematoma occurring at a distance from the transforaminal epidural injection site: A case report.

    • Sang-In Kim, Dong-Hyun Lee, Sun-Hee Kim, and Yong-Hyun Cho.
    • Department of Anesthesiology and Pain Medicine, Seoul Sacred Heart General Hospital, Seoul, Korea.
    • Medicine (Baltimore). 2019 Jul 1; 98 (30): e16654.

    RationaleTransforaminal 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 ConcernsAn 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.DiagnosisEmergency magnetic resonance imaging revealed fluid collection in the posterior epidural space at the T11-L1 level with central-canal stenosis.InterventionsEmergency hematoma evacuation was performed to remove the epidural hematoma.OutcomesAfter the surgery, the back pain disappeared.LessonsEpidural 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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