J Korean Orthop Assoc.  2014 Oct;49(5):381-384. 10.4055/jkoa.2014.49.5.381.

Epidural Abscess Following Epidural Catheterization for Painless Mobilization after Total Knee Arthroplasty

• Lee JH
• Wang SI
• Song KJ

• KMID: 2185174
• DOI: http://doi.org/10.4055/jkoa.2014.49.5.381

Abstract

Epidural analgesia is one of the effective methods for pain management after total knee arthroplasty. Although epidural analgesia has been reported to have very low epidural abscess rates, infection could be serious and life-threatening, if there is no early diagnosis and treatment. We report on a patient who developed an epidural abscess following epidural catheterization after total knee arthroplasty.

Keyword

knee; arthroplasty; epidural analgesia; epidural abscess

MeSH Terms

Analgesia, Epidural
Arthroplasty*
Catheterization*
Catheters*
Early Diagnosis
Epidural Abscess*
Humans
Knee*
Pain Management

Figure

• 

  Figure 1 Preoperative imaging studies of epidural abscess. (A) Preoperative sagittal T1-weighted enhanced magnetic resonance image shows protruded disc material at lumbar 4-5 level and epidural lesion showing a high signal, compressing thecal sac at lumbar 4-5 posterior epidural lesion. (B) Axial T1-weighted enhance magnetic resonance image shows an abscess lesion showing high signal at the right facet joint and adjacent muscle.

• 

  Figure 2 (A) Posterior spinal decompression and abscess drainage, back muscle debridement and antibiotic-cement beads insertion in the lesion was done as an emergency. (B) Two weeks later, posterolateral fusion using autogenous iliac bone and transpedicular screws was performed after beads removal.

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