title: Cervical Meningomyelitis After Lumbar Epidural Steroid Injection.
abstract: Epidural steroid injections (ESI) are a common treatment for back pain management. ESI-related complications have increased with the growing number of procedures. We report a case of cervical meningomyelitis followed by multiple lumbar ESI. A 60-year-old male with diabetes mellitus presented to our hospital with severe neck pain. He had a history of multiple lumbar injections from a local pain clinic. After admission, high fever and elevated inflammatory values were detected. L-spine magnetic resonance imaging (MRI) revealed hematoma in the S1 epidural space. Antibiotic treatment began under the diagnosis of a lumbar epidural abscess. Despite the treatment, he started to complain of weakness in both lower extremities. Three days later, the weakness progressed to both upper extremities. C-spine MRI revealed cervical leptomeningeal enhancement in the medulla oblongata and cervical spinal cord. Removal of the epidural abscess was performed, but there was no neurological improvement.
authors.affiliation: Department of Rehabilitation Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea.
authors.forename: Yujin
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Department of Rehabilitation Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea.
authors.forename: Joon-Sung
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Rehabilitation Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Kim
keywords: Epidural abscess; Epidural injections; Myelitis