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A sheared Racz catheter in cervical epidural space for thirty months: a case report.

Kang JH, Choi H, Kim JS, Lee MK, Park HJ - Korean J Anesthesiol (2015)

Bottom Line: Percutaneous epidural neuroplasty may lead to complications such as hematoma, infection, epidural abscess, meningitis, hypotension, respiratory depression, urinary and fecal dysfunction, sexual dysfunction and paresthesia.Other technical complications may include shearing or tearing, misplacement, blockage and migration of the catheter.We report a case of a 41-year-old female patient, who underwent surgical removal of a sheared catheter, which was retained for 30 months after cervical Racz neuroplasty.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.

ABSTRACT
Percutaneous epidural neuroplasty may lead to complications such as hematoma, infection, epidural abscess, meningitis, hypotension, respiratory depression, urinary and fecal dysfunction, sexual dysfunction and paresthesia. Other technical complications may include shearing or tearing, misplacement, blockage and migration of the catheter. We report a case of a 41-year-old female patient, who underwent surgical removal of a sheared catheter, which was retained for 30 months after cervical Racz neuroplasty.

No MeSH data available.


Related in: MedlinePlus

A computed tomography (CT) image before catheter fragment removal, (A) Transverse section, (B) Sagittal section, (C) Coronal section. The catheter fragment tip at the right C6-7 foraminal zone, without knotting or looping of the catheter.
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Figure 2: A computed tomography (CT) image before catheter fragment removal, (A) Transverse section, (B) Sagittal section, (C) Coronal section. The catheter fragment tip at the right C6-7 foraminal zone, without knotting or looping of the catheter.

Mentions: During the procedure, we found a foreign body in the cervical epidural space by fluoroscopy (Fig. 1). It resembled a Racz catheter fragment inserted 30 months previously. C-spine computed tomography images were obtained to determine the exact location of the proximal and distal tip of the catheter and whether it was knotted or looped. We confirmed that the tip of the catheter was at the right C6-7 foraminal zone (Fig. 2). We decided that surgical removal was necessary because of the presence of neurologic symptoms. The patient consented, and we consulted a neurosurgeon for surgical removal of the catheter fragment. Two weeks later, it was removed under fluoroscopy in the operating room. After a linear skin incision on the T1-2 level, the paraspinal muscle and interspinous ligament were dissected. The distal sheared tip of the catheter located at a 2 cm depth from skin, was removed. There was no knotting or looping in the removed catheter (Fig. 3). Findings during the operation were not suggestive of any fibrosis or granuloma tissue formation. The patient's symptom subsided immediately after surgery. During the 9 months post-surgical follow-up, the patient had no neurologic symptoms, nor pain in the neck and arm.


A sheared Racz catheter in cervical epidural space for thirty months: a case report.

Kang JH, Choi H, Kim JS, Lee MK, Park HJ - Korean J Anesthesiol (2015)

A computed tomography (CT) image before catheter fragment removal, (A) Transverse section, (B) Sagittal section, (C) Coronal section. The catheter fragment tip at the right C6-7 foraminal zone, without knotting or looping of the catheter.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4384411&req=5

Figure 2: A computed tomography (CT) image before catheter fragment removal, (A) Transverse section, (B) Sagittal section, (C) Coronal section. The catheter fragment tip at the right C6-7 foraminal zone, without knotting or looping of the catheter.
Mentions: During the procedure, we found a foreign body in the cervical epidural space by fluoroscopy (Fig. 1). It resembled a Racz catheter fragment inserted 30 months previously. C-spine computed tomography images were obtained to determine the exact location of the proximal and distal tip of the catheter and whether it was knotted or looped. We confirmed that the tip of the catheter was at the right C6-7 foraminal zone (Fig. 2). We decided that surgical removal was necessary because of the presence of neurologic symptoms. The patient consented, and we consulted a neurosurgeon for surgical removal of the catheter fragment. Two weeks later, it was removed under fluoroscopy in the operating room. After a linear skin incision on the T1-2 level, the paraspinal muscle and interspinous ligament were dissected. The distal sheared tip of the catheter located at a 2 cm depth from skin, was removed. There was no knotting or looping in the removed catheter (Fig. 3). Findings during the operation were not suggestive of any fibrosis or granuloma tissue formation. The patient's symptom subsided immediately after surgery. During the 9 months post-surgical follow-up, the patient had no neurologic symptoms, nor pain in the neck and arm.

Bottom Line: Percutaneous epidural neuroplasty may lead to complications such as hematoma, infection, epidural abscess, meningitis, hypotension, respiratory depression, urinary and fecal dysfunction, sexual dysfunction and paresthesia.Other technical complications may include shearing or tearing, misplacement, blockage and migration of the catheter.We report a case of a 41-year-old female patient, who underwent surgical removal of a sheared catheter, which was retained for 30 months after cervical Racz neuroplasty.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.

ABSTRACT
Percutaneous epidural neuroplasty may lead to complications such as hematoma, infection, epidural abscess, meningitis, hypotension, respiratory depression, urinary and fecal dysfunction, sexual dysfunction and paresthesia. Other technical complications may include shearing or tearing, misplacement, blockage and migration of the catheter. We report a case of a 41-year-old female patient, who underwent surgical removal of a sheared catheter, which was retained for 30 months after cervical Racz neuroplasty.

No MeSH data available.


Related in: MedlinePlus