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UNINTENTIONAL REVERSIBLE IATROGENIC LOWER LIMB MOTOR DEFICIT AFTER SUBARACHNOID ANAESTHESIA DUE TO ABNORMAL LOCALIZATION OF THE LOWER BOUNDARY OF THE SPINAL CORD: A CLINICAL CASE.
Author(s): ,
Kamal, W.*
Affiliations:
Centre hospitalier Elyoussef. Halba., Department of anesthesiology and intensive care., Akkar., Lebanon
Golyanischev, M.
Affiliations:
Centre hospitalier Elyoussef. Halba., Department of anesthesiology and intensive care., Akkar., Lebanon
ESRA Academy. Kamal W. Sep 13, 2017; 190741; 213 Topic: SAFETY AND COMPLICATIONS OF REGIONAL ANAESTHESIA (RA)
Dr. Walid Kamal
Dr. Walid Kamal

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Abstract
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Background and Aims:

Modern international recommendations help anesthetists avoid side effects and complications of subarachnoid anesthesia (SAA). We described the clinical case of direct spinal cord injury during the conducting of the SAA to emphasize the importance of developing interdisciplinary recommendations for the prevention and treatment of complications of this genesis.

Methods:

Description

Results:

SAA for Patient A. was conducted according to planned indications, after standard preparation. The insertion of the needle into the subarachnoid space L2-L3 was without technical difficulties. After the needle entered the subarachnoid space, the patient marked dysesthesia (left limb). The position of the needle was changed to L3-L4 then the liquor was obtained with normal characteristics. Then spinal anaesthesia went without distinction. In the next day, some disorders were noted: pain, numbness, motor deficit in the left leg, which required consultation of a neuro surgeon. The treatment was prescribed, which had a positive effect for 10 days. Stable neurologic effects were not observed before discharge or screening through 12 months.

The presence of a low level of the spinal cord, which ends in L3-L4, had been revealed from the data of the IRM of the lumbar spine. This (Fig. 1, 2, 3), had confirmed the zones of the intramedullary hyper-signal in the T2 band and the isosignal in the T1 band more than 3.8 cm in height between L2-L3.

            Figure 1

Conclusions:

The urgency of the development of methods for the preliminary detection of risk factors for abnormalities in the structures of the spinal cord and recommendations for anaesthesia in these patients is shown.

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