Korean J Anesthesiol.  1988 Dec;21(6):1002-1006. 10.4097/kjae.1988.21.6.1002.

Continuous Transsacral Epidural Block in a Patient with Diffuse Idiopathic Skeletal Hyperostosis

• Park SS
• Yoon DM
• Kim YJ
• Oh HK

• KMID: 1933087
• DOI: http://doi.org/10.4097/kjae.1988.21.6.1002

Abstract

A 79-year-old male patient presented with a continuous transsacral epidural block for the treatment of herpes zoster pain on the right Tll-12 and Ll dermatome levels. However, it was impossible to introduce the Tuohy needle below the subcutaneous tissue. By the C-arm image intensifier, flowing calcifications of the lumbar paravertebral ligaments, except L5-Sl interspace, were observed. Thus, an epidural approach was tried at the L5-Sl interspace, but the Tuohy needle was introduced in the subarachnoid space instead of the epidural space. After an X-ray of the whole spine, diffuse idiopathetic skeletal hyperostosis was diagnosed. The Tuohy needle was introduced into the sacral canal through the second posterior sacral foramen and the epidural catheter was inserted about 15cm in length cephalad through the needle. The pain was controlled by the injection of 1% lidocaine and 0.5% bupivacaine every 3-4 hours continuously After 3 weeks this patient was discharged from hospital without any postherpetic sequelae.

Keyword

Herpes zoster Transsacral epidural block; Diffuse idiopathic skeletal hyperostosis

MeSH Terms

Aged
Bupivacaine
Catheters
Epidural Space
Herpes Zoster
Humans
Hyperostosis
Hyperostosis, Diffuse Idiopathic Skeletal*
Lidocaine
Ligaments
Male
Needles
Spine
Subarachnoid Space
Subcutaneous Tissue
Bupivacaine
Lidocaine