Kim TH, Shin JJ, Lee WY. Surgical treatment of a broken neuroplasty catheter in the epidural space: a case report.
J Med Case Rep 2016;
10:277. [PMID:
27716451 PMCID:
PMC5052922 DOI:
10.1186/s13256-016-1064-7]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 09/12/2016] [Indexed: 11/10/2022] Open
Abstract
Background
Percutaneous epidural neuroplasty with a Racz catheter is widely used to treat radicular pain caused by spinal stenosis or a herniated intervertebral disc. The breakage or shearing of an epidural catheter, particularly a percutaneous epidural neuroplasty catheter, is reported as a rare complication. There has been a controversy over whether surgical removal of a shorn epidural catheter is needed. Until now, only three cases related to sheared Racz neuroplasty catheters have been reported. We report a case of a neuroplasty catheter which completely broke when it was inserted into the epidural space, and compressed root symptoms were exacerbated by the broken catheter.
Case presentation
A 68-year-old Asian man with leg pain and lower back pain caused by lumbar vertebral body 4 to lumbar vertebral body 5 intervertebral disc herniation and stenosis underwent percutaneous epidural neuroplasty. During the procedure, the epidural neuroplasty catheter was trapped in the left foraminal portion and broke. Our patient complained of left-side leg pain and numbness. Surgery performed to remove the broken catheter led to complete resolution of his leg pain and numbness.
Conclusions
We report a rare case of catheter breakage occurring during epidural neuroplasty. We suggest surgical removal because the implanted catheter can aggravate a patient’s symptoms and lead to the development of neurologic deficits due to infection, fibrosis, or mechanical neural irritation.
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