척수마취 후 발생한 마비증후군
Cauda Equina Syndrome Following Spinal Anesthesia
양정인, 전아영, 임소영, 최은희, 장기언, 박동식,
소속 상세정보
양정인 ( Yang Jung-In )
한림대학교 의과대학 재활의학교실
전아영 ( Jun Ah-Young )
한림대학교 의과대학 재활의학교실
임소영 ( Lim So-Young )
한림대학교 의과대학 마취통증의학교실
최은희 ( Choi Eun-Hi )
한림대학교 의과대학 재활의학교실
장기언 ( Jang Ki-Un )
한림대학교 의과대학 재활의학교실
박동식 ( Park Dong-Sik )
한림대학교 의과대학 재활의학교실
KMID : 0860920050070010069
Abstract
Cauda equina syndrome after regional anesthesia is a serious and devastating complication. We report a case of cauda equina syndrome following spinal anesthesia with 0.5% bupivacaine. A 35-year-old male complained of voiding difficulty, severe pain and weakness on his left lower extremity after spinal anesthesia for arthroscopic knee surgery. Electrodiagnostic examination revealed asymmetric bilateral lumbosacral radiculopathies compatible with cauda equina syndrome. The MRI findings showed enhancement of lumbosacral nerve roots, which might indicate breakdown of the blood-nerve barrier by noninfectious inflammatory process. He was treated with medication, bladder training and physical therapy, and finally partially recovered one year later after symptoms onset. Although the mechanisms causing such
neural injures are not fully known, the MRI findings showing enhancement of spinal nerve roots in this case may support the theory of a direct toxic effect of chemical agents and/or autoimmune reaction.
키워드
Cauda eqina syndrome;Spinal anesthesia;Spinal nerve root inflammation
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