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We reviewed the clinical features of 12 patients with neurologic complications following lumbar epidural anesthesia or analgesia.Eleven patients experienced lumbosacral radiculopathy or polyradiculopathy and of these,10 received epidural anesthesia or analgesia and one received subarachnoid injection of medication after intended epidural anesthesia. One patient suffered a moderately severe thoracic myelopathy in the setting of unintended spinal anesthesia.The two patients with more severe polyradiculopathy had severe lumbar spinal stenosis on MRI.The other patients experienced mild to moderate neurologic deficits most often involving the L2 root,and MRIs,when performed were unremarkable.EMG on three patients helped to localize the lesions to the lumbosacral roots and to quantify the extent of axonal loss.Ten patients were ambulatory upon discharge from the hospital and had good neurologic outcome.One patient with severe polyradiculopathy did not improve after four years and had severe motor axonal loss based upon electrodiagnostic studies.The patient with a thoracic myelopathy was ambulatory four months after onset.Although generally a safe procedure with low frequency of complications,lumbar epidural anesthesia or analgesia occasionally causes neurologic sequelae such as radiculopathy or myelopathy.Neurologic complications may be more severe in the presence of spinal stenosis or after inadvertent subarachnoid injection of anesthesia or analgesic agent. |
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analgesia,epidural
anesthesia,epidural
cauda equina,lesion of
electromyogram
iatrogenic neurologic disorders
leg weakness,bilateral
leg weakness,unilateral
lumbosacral radiculopathy
MRI
MRI,abnormal
myelopathy
pain
polyradiculoneuropathy
prognosis
radiculopathy
review article
risk factors
spinal stenosis
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