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Cord injury after spinal block for caesarean section
  1. Ramkumar Sugumaran1,
  2. Sunil K Narayan1,
  3. Atul Goel1,
  4. Pankaj Kundra2
  1. 1 Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
  2. 2 Anaesthesia and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
  1. Correspondence to Dr Sunil K Narayan, Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India; sunil.narayan{at}jipmer.edu.in

https://doi.org/10.1136/practneurol-2020-002760

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    The most common causes of nerve injury following regional anaesthesia are compression from haematoma, direct trauma and chemical neuritis.1 We describe a 26-year-old woman who had undergone an emergency caesarean section under spinal anaesthesia for fetal distress (category 1) in a peripheral hospital. The anaesthetist had used a 25-guage needle, while attempting to access the L3-L4 and L4-L5 intervertebral spaces in the midline, with the patient in the left lateral decubitus position. During the needle insertion, the patient experienced severe pain radiating down her right leg. Following the procedure, she developed right foot drop, right leg numbness and dysesthesia in an L4 to S1 dermatomal distribution. Five months after the delivery, the patient was referred to …

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    Footnotes

    • Contributors RS clinically analysed the case including the images and reviewed the drafts. SKN conceptualised the importance of and need for writing this report, analysed the history and reviewed the drafts. AG collected the initial data and wrote the first draft of the paper. PK critically evaluated the data, reviewed and contributed to the manuscript especially to various aspects of spinal anaesthesia procedure and its potential complications.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None.

    • Provenance and peer review Not commissioned. Externally peer reviewed by Khalid Hamandi and Holger Allroggen, Cardiff, UK.

    Linked Articles

    • Editors’ commentary
      Highlights from this issue
      Geraint N Fuller Phil E M Smith
      Practical Neurology 2021; 21 183-183 Published Online First: 17 May 2021. doi: 10.1136/practneurol-2021-003071

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