Korean J Pain.  2013 Jul;26(3):286-290. 10.3344/kjp.2013.26.3.286.

Motor Weakness after Caudal Epidural Injection Using the Air-acceptance Test

• Lee MH
• Han CS
• Lee SH
• Lee JH
• Choi EM
• Choi YR
• Chung MH

• KMID: 2074030
• DOI: http://doi.org/10.3344/kjp.2013.26.3.286

Abstract

Air injected into the epidural space may spread along the nerves of the paravertebral space. Depending on the location of the air, neurologic complications such as multiradicular syndrome, lumbar root compression, and even paraplegia may occur. However, cases of motor weakness caused by air bubbles after caudal epidural injection are rare. A 44-year-old female patient received a caudal epidural injection after an air-acceptance test. Four hours later, she complained of motor weakness in the right lower extremity and numbness of the S1 dermatome. Magnetic resonance imaging showed no anomalies other than an air bubble measuring 13 mm in length and 0.337 ml in volume positioned near the right S1 root. Her symptoms completely regressed within 48 hours.

Keyword

caudal epidural block; complications; epidural air; epidural injection

MeSH Terms

Epidural Space
Female
Humans
Hypesthesia
Injections, Epidural
Lower Extremity
Magnetic Resonance Imaging
Paraplegia

Figure

• 

  Fig. 1 MRI. T1-weighted MRI shows a low signal lesion, identified as an air bubble (white arrow) adjacent to the right S1 root (black arrow).

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  Fig. 2 MRI. T2-weighted MRI shows a low signal lesion, identified as an air bubble (white arrow) adjacent to the right S1 root (black arrow).

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