Ann Rehabil Med.  2015 Jun;39(3):504-507. 10.5535/arm.2015.39.3.504.

Cervical Meningomyelitis After Lumbar Epidural Steroid Injection

• Lee Y
• Kim JS
• Kim JY

• KMID: 2165657
• DOI: http://doi.org/10.5535/arm.2015.39.3.504

Abstract

Epidural steroid injections (ESI) are a common treatment for back pain management. ESI-related complications have increased with the growing number of procedures. We report a case of cervical meningomyelitis followed by multiple lumbar ESI. A 60-year-old male with diabetes mellitus presented to our hospital with severe neck pain. He had a history of multiple lumbar injections from a local pain clinic. After admission, high fever and elevated inflammatory values were detected. L-spine magnetic resonance imaging (MRI) revealed hematoma in the S1 epidural space. Antibiotic treatment began under the diagnosis of a lumbar epidural abscess. Despite the treatment, he started to complain of weakness in both lower extremities. Three days later, the weakness progressed to both upper extremities. C-spine MRI revealed cervical leptomeningeal enhancement in the medulla oblongata and cervical spinal cord. Removal of the epidural abscess was performed, but there was no neurological improvement.

Keyword

Epidural injections; Myelitis; Epidural abscess

MeSH Terms

Back Pain
Diabetes Mellitus
Diagnosis
Epidural Abscess
Epidural Space
Fever
Hematoma
Humans
Injections, Epidural
Lower Extremity
Magnetic Resonance Imaging
Male
Medulla Oblongata
Middle Aged
Myelitis
Neck Pain
Pain Clinics
Spinal Cord
Upper Extremity