The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Paraplegia Following Intercostal Nerve Neurolysis with Alcohol and Thoracic Epidural Injection in Lung Cancer Patient

  • Kim, Byoung Ho (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center) ;
  • No, Min Young (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center) ;
  • Han, Sang Ju (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center) ;
  • Park, Cheol Hwan (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center) ;
  • Kim, Jae Hun (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center)
  • Received : 2014.12.30
  • Accepted : 2015.01.02
  • Published : 2015.04.01
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Abstract

The goal of cancer treatment is generally pain reduction and function recovery. However, drug therapy does not treat pain adequately in approximately 43% of patients, and the latter may have to undergo a nerve block or neurolysis. In the case reported here, a 42-year-old female patient with lung cancer (adenocarcinoma) developed paraplegia after receiving T8-10 and $11^{th}$ intercostal nerve neurolysis and T9-10 interlaminar epidural steroid injections. An MRI results revealed extensive swelling of the spinal cord between the T4 spinal cord and conus medullaris, and T5, 7-11, and L1 bone metastasis. Although steroid therapy was administered, the paraplegia did not improve.

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References

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  1. Spinal Cord Ischemia Secondary to Epidural Metastasis from Small Cell Lung Carcinoma vol.18, pp.1941-5923, 2017, https://doi.org/10.12659/AJCR.902813
  2. Visualization of injectate spread of intercostal nerve block: a cadaveric study vol.4, pp.1, 2015, https://doi.org/10.1186/s40981-018-0204-z
  3. Anesthesia upstream of the alcoholic lesion point alleviates the pain of alcohol neurolysis for intercostal neuralgia: a prospective randomized clinical trial vol.75, pp.None, 2015, https://doi.org/10.6061/clinics/2020/e1296