title: Spinal cord injury: a rare complication following thoracic epidural anesthesia for percutaneous nephrolithotomy.
abstract: Herein, we report a rare instance of paraplegia following percutaneous nephrolithotomy under thoracic epidural anesthesia in a conscious patient. The possible factors include low body mass index, chronic renal failure, and multiple "in and out" needle passes during the procedure. Direct cord trauma with epidural bloody collection resulted in the neurological damage. However, the patient did not show signs of spinal cord trauma during the needle injury, possibly due to a prior accidental subarachnoid block. This not only delayed the recognition of the disorder, but also delayed treatment, consequently resulting in permanent paraplegia. Careful monitoring after epidural blocking should be undertaken in order to allow the early detection of mismanagement and limit the extent of neurologic injury.
authors: Department of Urology, Chhatrapati Shahuji Maharaj Medical University, Erstwhile King George Medical College, Lucknow, UP India. deepaknagathan@rediffmail.com
authors: Deepak Sharanappa
authors: DS
authors: Nagathan
authors: Bhupendra Pal
authors: BP
authors: Singh
authors: Swaroopa
authors: S
authors: Ghatanatti
authors: S N
authors: SN
authors: Sankhwar
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D013119:Spinal Cord Injuries / Q000209:etiology*; D013904:Thoracic Vertebrae