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Anestesia Analgesia Reanimación

On-line version ISSN 1688-1273

Abstract

AYALA, Walter  and  AYALA, Santiago. Inyección intradiscal durante un procedimiento epidural transforaminal lumbar. Anest Analg Reanim [online]. 2011, vol.24, n.2, pp.75-78. ISSN 1688-1273.

A case of unexpected intradiscal injection during a lumbar transforaminal epidural is reported. It was observed in one patient with lumbar radicular pain for extruded disc scheduled for left L4, L5 transforaminal injection. With the needle placed under the pedicle of left L4-L5 intervertebral foramen, the common periradicular L4 root image and L4-L5 discogram were seen with transitory lumbar pain when the contrast was injected. Only the sleeve root normal pattern was observed when the needle was withdrawn sligthtly. The epidural steroid and one prophylactic intravenous antibiotic were administrated. The L5 transforaminal injection was uneventfully. The outcome was without clinical or laboratory signs of infection. Is a rare complication but with potential risk of discitis. Intradiscal injection risk factors are discussed, like needle position, cephalad migration of extruded disc, lateral disc herniation and foraminal stenosis. It´s a complication that can be seen even with an appropriate technique. Prophylactic antiobiotics and follow-up are recommended

Keywords : Intradiscal injection; transforaminal injection.

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