Ann Rehabil Med.  2016 Oct;40(5):949-954. 10.5535/arm.2016.40.5.949.

Acute Paraplegia After Lumbar Steroid Injection in Patients With Spinal Dural Arteriovenous Fistulas: Case Reports

• Kim S
• Choi Y
• Park J
• Sung DH

• KMID: 2382929
• DOI: http://doi.org/10.5535/arm.2016.40.5.949

Abstract

Spinal dural arteriovenous fistulas (SDAVFs) are the most common type of spinal vascular malformations. However, SDAVFs are still underdiagnosed entities because their clinical symptoms are usually non-specific, as they include low back pain or radiating pain to the limb. There have been several reports of acute paraplegia after lumbar epidural steroid injections in patients with SDAVFs. We present 4 patients with SDAVFs who received lumbar steroid injection. Among the 4 cases, acute paraplegia developed in 2 cases that received a larger volume of injectate than the other cases. Thus, we are suggesting that the volume of injectate may be a contributing factor for acute paraplegia after lumbar steroid injection in patients with SDAVFs.

Keyword

Spine; Arteriovenous fistula; Injections; Epidural; Steroids; Paraplegia

MeSH Terms

Arteriovenous Fistula
Central Nervous System Vascular Malformations*
Extremities
Humans
Low Back Pain
Paraplegia*
Spine
Steroids
Vascular Malformations
Steroids