title: Chronic inflammatory granuloma mimics clinical manifestations of lumbar spinal stenosis after acupuncture: a case report.
abstract: METHODS
  A case report and review of the literature.
  
  
  OBJECTIVE
  To present a case of chronic inflammatory epidural granuloma formed after acupuncture.
  
  
  BACKGROUND
  A number of cases of complications resulting from acupuncture have been reported, including acute infection, hemorrhage, and direct injury to internal organs or neural tissues. However, to the best of our knowledge, there has been no report of epidural granuloma formed following acupuncture and mimicking clinical manifestations of lumbar stenosis.
  
  
  METHODS
  A 68-year-old woman suffered from low back pain and sciatica aggravated by acupuncture. We reviewed her medical record, imaging studies, microscopic findings of the mass, and related literature.
  
  
  RESULTS
  Microscopic examination revealed the mass as a chronic inflammatory granuloma. From her previous history and imaging study, the mass, which compressed the lumbar forth nerve and dural sac,was highly suspected to have been formed after acupuncture. Surgical decompression and excision of the epidural mass relieved her symptoms.
  
  
  CONCLUSIONS
  Chronic inflammatory granuloma may be formed as a complication of acupuncture. Under such circumstances, surgical excision of the mass may be an effective way of relieving the symptoms.
authors.affiliation: Department of Orthopedic Surgery, Kang-Nam St. Mary's Hospital, the Catholic University of Korea, College of Medicine, Seoul, Korea. kyh@cmc.cuk.ac.kr
authors.forename: Kee-Yong
authors.initials: KY
authors.lastname: Ha
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Kim
mesh_terms: D015667:Acupuncture Analgesia / Q000009:adverse effects*; D000368:Aged; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004824:Epidural Space; D005260:Female; D006099:Granuloma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D017116:Low Back Pain / Q000209:etiology; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D012585:Sciatica / Q000209:etiology; D013130:Spinal Stenosis / Q000175:diagnosis*