Foraminal stenosis complicating retained broken epidural needle tip -A case report-

Abstract

Lumbar epidural anesthesia is useful in a variety of chronic benign pain syndromes, including lumbar radiculopathy, low back pain syndrome, spinal stenosis, and vertebral compression fractures. Given the increased number of epidural nerve blocks being performed, some have reported unexplained complications of a transient or permanent nature and with varying degrees of severity. However, no case has been reported of a broken epidural needle tip retained in the lumbar facet joint area. This represents the first reported case presentation of foraminal stenosis developing in a patient after a retained epidural needle tip.

Paraparesia aguda por hemangioma vertebral agresivo. Reporte de dos casos y revisión bibliográfica

“…Los estudios previos muestran patrones poco habituales de dolor. 7,8 Nuestra paciente permaneció con un dolor radicular derecho insidioso durante varios meses, luego de la cesárea, que no desaparecía con el tratamiento conservador.…”

Broken Epidural Catheter: An Anesthesiologist’s Dilemma

“…It got relieved with removal of catheter and reactive scar tissue [7]. Rare case of low back ache due to foramina stenosis has been reported [8]. In such cases, surgical intervention must be done for the removal of the catheter.…”

Surgical Management of the Retained Epidural Catheter Fragment Complicated by Postoperative Phlegmon

“…It has been suggested that because retained fragments are sterile and unlikely to cause serious neurological sequelae, it is acceptable for them to be left in situ [7]. Multiple complications have been reported related to retained catheter fragments, however, including catheter tip migration into the intrathecal space with resulting CSF leak [12], nerve entrapment with radicular pain [13], formation of scar tissue around the catheter fragment resulting in spinal stenosis [8], and foraminal stenosis [14], infection [15], and delayed subdural hematoma formation [16][17][18][19][20][21]. Therefore, even without immediate evidence of neurologic or infectious sequelae, providing patients the option of surgical removal versus watchful waiting is still reasonable [9,17].…”