Acute Paraplegia Following Lumbar Puncture in a Patient with Cervical Disc Herniation.

Doh, Jae Won; Hwang, Sun Chul; Yun, Suck Man; Bae, Hack Gun; Lee, Kyeong Seok; Yun, Il Gyu; Choi, Soon Kwan; Byun, Bark Jang

Case Report

Journal of Korean Neurosurgical Society 2001;30(8): 1042-1046.

Jae Won Doh, Sun Chul Hwang, Suck Man Yun, Hack Gun Bae, Kyeong Seok Lee, Il Gyu Yun, Soon Kwan Choi, Bark Jang Byun

Department of Neurosurgery, Soonchunhyang University Chonan Hospital, Chonan, Korea.

ABSTRACT

The incidence of paraplegia following drain of cerebrospinal fluid(CSF) by lumbar puncure below a spinal block is rare, and most of them occurred in spinal tumor. We report a case of acute paraplegia following lumbar puncture for computed tomography myelography(CTM) in a 42-year-old man who sustained a cervical disc herniation. Four hours after lumbar puncture for CTM, sudden paraplegia was developed. After emergent anterior cervical discectomy and fusion with cervical plating, the patient recovered completely. To the authors' knowledge, this is the first case of spinal shock complicating lumbar puncture for routine myelography in a patient with cervical disc herniation. The prompt recognition of this unusual complication of lumbar puncture may lead to good clinical outcome. Instead of CTM requiring lumbar puncture, MRI should be considered as the initial diagnostic procedure in a patient of cervical disc herniation associated with myelopathy. We discuss the possible mechanisms of acute paraplegia following lumbar puncture with literature review.

Key Words: Lumbar puncture; Myelography; Paraplegia; Cervical disc herniation