Pneumorrhachis mimicking meningitis after a paramedian lumbar interlaminar injection

Clin J Pain. 2011 May;27(4):355-6. doi: 10.1097/AJP.0b013e3181f1eabb.

Abstract

We report a case of a 76-year-old female with chronic back pain owing to a degenerative disc disease at L5 to S1. She underwent a paramedian lumbar interlaminar injection in the prone position at the level of L5-S1 using loss of resistance technique and without fluoroscopic guidance. The patient was admitted to the intensive care unit on the day after the procedure with objective signs of meningeal irritation. A computed tomography scan of the spine showed presence of multiple air levels within the spinal canal. The patient's symptoms resolved spontaneously and she was discharged to home the next day.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Back Pain / etiology
  • Bupivacaine / administration & dosage
  • Chronic Disease
  • Female
  • Humans
  • Injections, Spinal / adverse effects*
  • Intervertebral Disc Degeneration / complications
  • Lumbar Vertebrae
  • Meningitis / etiology*
  • Methylprednisolone / administration & dosage
  • Tomography, X-Ray Computed

Substances

  • Methylprednisolone
  • Bupivacaine