title: Surgical treatment of a broken neuroplasty catheter in the epidural space: a case report.
abstract: BACKGROUND
  Percutaneous epidural neuroplasty with a Racz catheter is widely used to treat radicular pain caused by spinal stenosis or a herniated intervertebral disc. The breakage or shearing of an epidural catheter, particularly a percutaneous epidural neuroplasty catheter, is reported as a rare complication. There has been a controversy over whether surgical removal of a shorn epidural catheter is needed. Until now, only three cases related to sheared Racz neuroplasty catheters have been reported. We report a case of a neuroplasty catheter which completely broke when it was inserted into the epidural space, and compressed root symptoms were exacerbated by the broken catheter.
  
  
  METHODS
  A 68-year-old Asian man with leg pain and lower back pain caused by lumbar vertebral body 4 to lumbar vertebral body 5 intervertebral disc herniation and stenosis underwent percutaneous epidural neuroplasty. During the procedure, the epidural neuroplasty catheter was trapped in the left foraminal portion and broke. Our patient complained of left-side leg pain and numbness. Surgery performed to remove the broken catheter led to complete resolution of his leg pain and numbness.
  
  
  CONCLUSIONS
  We report a rare case of catheter breakage occurring during epidural neuroplasty. We suggest surgical removal because the implanted catheter can aggravate a patient's symptoms and lead to the development of neurologic deficits due to infection, fibrosis, or mechanical neural irritation.
authors.affiliation: Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine, Dongil-ro 1342, Nowon-gu, Seoul, 01757, Korea.
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine, Dongil-ro 1342, Nowon-gu, Seoul, 01757, Korea. junjaeshin@gmail.com.
authors.forename: Jun Jae
authors.initials: JJ
authors.lastname: Shin
authors.affiliation: Department of Anesthesiology, Sanggye Paik Hospital, Inje University College of Medicine, Dongil-ro 1342, Nowon-gu, Seoul, 01757, Korea.
authors.forename: Woo Yong
authors.initials: WY
authors.lastname: Lee
mesh_terms: D000368:Aged; D002404:Catheterization / Q000009:adverse effects*; D057785:Catheters / Q000009:adverse effects*; D020878:Device Removal / Q000379:methods*; D004824:Epidural Space / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D004868:Equipment Failure; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009407:Nerve Block / Q000379:methods; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D016896:Treatment Outcome
keywords: Catheter breakage; Complications; Epidural catheter; Intervertebral disc herniation; Lower back pain; Lumbar spine; Neuroplasty; Surgery