Transient paraplegia from intraoperative intercostal nerve block after transthoracic discectomy.
OBJECTIVE
To present two patients with transient paraplegia from intercostal nerve blocks after transthoracic discectomy.


METHODS
The preoperative, intraoperative, and postoperative courses of two patients who underwent transthoracic discectomies were reviewed. A literature review of complications from thoracic disc excisions and intercostal nerve blocks also was conducted.


RESULTS
Two patients experienced transient paraplegia from intercostal nerve blockade after thoracotomy for thoracic discectomies. Although transient paraplegia (or regional anesthesia) after intercostal nerve blocks has been reported and is consistent with the clinical course seen in our two patients, it has not been reported after thoracotomy for decompression of the spinal cord.


CONCLUSIONS
Because of the inherent risk of neurologic injury after thoracic discectomy, the authors discourage the use of intercostal nerve blocks for relieving postoperative pain after transthoracic discectomy.
Ghanayem
A J
AJ
Reconstructive and Traumatic Spine Center, University Hospitals, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Bohlman
H H
HH
D000368:Aged; D002045:Bupivacaine; D017586:Diskectomy; D005260:Female; D006801:Humans; D007367:Intercostal Nerves; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D007430:Intraoperative Care / Q000009:adverse effects; D016343:Monitoring, Intraoperative; D009407:Nerve Block / Q000009:adverse effects*; D010149:Postoperative Pain / Q000517:prevention & control*; D010264:Paraplegia / Q000209:etiology*; D013904:Thoracic Vertebrae / Q000601:surgery*
D002045:Bupivacaine