First case of mechanical compression by methylprednisolone crystals following transforaminal lumbar nerve root block for left sciatic pain leading to hyperesthesia and progressive weakness: A case report

Lumbosacral nerve root blocks and epidural corticosteroid injections are commonly used for short-term pain relief among patients with degenerative spinal disc disease. Serious complications following these rare, there only a few published papers on this subject. It is important that spine surgeons aware of the potential complications, possible factors contribute to such complications. 32-year-old Lebanese female presented progressive weakness hyperesthesia transforaminal lumbar particulate injection. The case was managed by surgical decompression. Neurological transforaminal/selective block most feared all associated epidurals blocks. has been hypothesized complication mainly due cord infarct from crystal. However, no previous reports could be mechanical compression caused crystals themselves as confirmed in current case. Progressive effect particles injectate. Such simply avoided use more dilutional volume local anaesthetic agent and/or using non-particulate order avoid adherence sheath. This first post-nerve neurological crystals.