Cauda Equina Syndrome Following Spinal Anesthesia

J Korean Assoc EMG Electrodiagn Med 2005;7(1):69-72.
Published online May 10, 2005.

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.

Key Words: Cauda eqina syndrome, Spinal anesthesia, Spinal nerve root inflammation