요부교감신경차단으로 척수경색 환자의 하지통증 치료 -증례보고-

Lumbar Sympathetic Block for Spinal Cord Infarction Patient -A case report-

  • 김동희 (단국대학교 의과대학 마취통증의학교실) ;
  • 박상욱 (단국대학교 의과대학 마취통증의학교실) ;
  • 김형지 (단국대학교 의과대학 비뇨기과학교실)
  • Kim, Dong Hee (Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University) ;
  • Park, Sang Wook (Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University) ;
  • Kim, Hyung Jee (Department of Urology, College of Medicine, Dankook University)
  • 투고 : 2006.05.30
  • 심사 : 2006.10.09
  • 발행 : 2006.12.30

초록

This report describes a case of spinal cord infarction after acupuncture. The patient was treated with lumbar sympathetic block with using C-arm fluoroscopy. A 66-year-old patient with chronic low back pain and radiating pain in the lower limb was treated with acupuncture and he suddenly had a loss of motor and sensory of both lower extremities. His clinical presentaion and neuroimaging studies were consistent with spinal cord infarction. He was treated with steroid megatherapy and he showed improved in motor function, but there was no pain relief despite the phamacological treatments that were combined with caudal blockade. He visited to our hospital and had lumbar sympathetic blockade performed. The pain was relieved without any related complication after 1 month (VAS $9/10{\rightarrow}2/10$), and he has been content with the results of treatment.

키워드

참고문헌

  1. Singh U, silver JR, Welphy NC: Hyportensive infarction of the spinal cord. Paraplegia 1994; 32: 314-22 https://doi.org/10.1038/sc.1994.54
  2. Sandson TA, Freidman JH: Spinal cord infarction: report of 8 cases and review of the literature. Medicine 1989; 68: 282-92 https://doi.org/10.1097/00005792-198909000-00003
  3. Yamashita H, Tsukayama H, White AR, Tanno Y, Sugishita C, Ernst E: Systematic review of adverse events following acupuncture: the Japanese literature. Complement Ther Med 2001; 9:98-104 https://doi.org/10.1054/ctim.2001.0446
  4. Cheshire WP, Santos CC, Massey EW, Howard JF Jr: Spinal cord infarction: etiology and outcome. Neurology 1996; 47: 321-330 https://doi.org/10.1212/WNL.47.2.321
  5. Rampes H, James R: Complications of acupuncture. Acupunct Med 1995; 13: 26-33 https://doi.org/10.1136/aim.13.1.26
  6. Norheim AJ: Adverse effects of acupuncture: a study of the literature for the years 1981-1994. J Altern Complement Med 1996; 2: 291-7 https://doi.org/10.1089/acm.1996.2.291
  7. Blumbergs PC, Byrne E: Hypotensive central infarction of the spinal cord. J Neurol Neurosurg Psychiatry 1980; 43: 751-3 https://doi.org/10.1136/jnnp.43.8.751
  8. Foo D, Rossier AB: Anterior spinal artery syndrome and its natural history. Paraplegia 1983; 21: 1-10 https://doi.org/10.1038/sc.1983.1
  9. Mori H, Okada M: Experimental study about broken needles. J Jpn society Acupunct 1971; 20: 19-21
  10. Ilhan A, Alioglu Z, Adanir M, Ozmenoglu M: Transverse myelopathy after acupuncture therapy: a case report. Acupunct Electrother Res 1995; 20: 191-4 https://doi.org/10.3727/036012995816357078
  11. Isu T, Iwasaki Y, Sasaki H, Abe H: Spinal cord and root injuries due to glass fragments and acupuncture needles. Surgical Neurology 1985; 23: 255-60 https://doi.org/10.1016/0090-3019(85)90091-6
  12. Yutani C, Imakita M, Ishibashi-Ueda H, Hatanaka K, Waki R, Ogawa M, et al: Cerebro-spinal infarction caused by atheromatous emboli. Acta Pathol Jpn 1985; 35: 789-801
  13. Ludwig MA, Burns SP: Spinal cord infarction following cervical transforaminal epidural injection: a case report. Spine 2005; 30:266-8 https://doi.org/10.1097/01.brs.0000162401.47054.00
  14. Joseph G, Santosh C, Marimuthu R, Fraser MH, McLean AN: Spinal cord infarction due to a self-inflicted needle stick injury. Spinal Cord 2004; 42: 655-8 https://doi.org/10.1038/sj.sc.3101619
  15. Absalom AR, Martinelli G, Scott NB: Spinal cord injury caused by direct damage by local anaesthetic infiltration needle. Br J Anaesth 2001; 87: 512-5 https://doi.org/10.1093/bja/87.3.512
  16. Kao MC, Tsai SK, Tsou MY, Lee HK, Guo WY, Hu JS: Paraplegia after delayed detection of inadvertent spinal cord injury during thoracic epidural catheterization in an anesthetized elderly patient. Anesth Analg 2004; 99: 580-3