Foraminal Hematoma Following Lumbar Transforaminal Steroid Injection Causing Reversible Motor Deficit: A Case Report

Lumbar radiculopathy is a common disorder with a prevalence of 2.2-8% [1]. Mechanical compression by a herniated lumbar disc or foraminal stenosis, along with an induced inflammatory response, is thought to underlie radicular pain [2]. Transforaminal epidural steroid injections (TFESI) are widely used for the management of lumbar radicular pain provoked by herniated discopathy and spinal stenosis. The injections deliver glucocorticoids and anesthetics through the intervertebral foramen into the epidural space along the exiting spinal nerves [3]. While the anesthetic component provides immediate pain relief, steroids provide a longer lasting anti-inflammatory effect [4]. As such, the transforaminal route has become popular as a therapeutic intervention which permits the delivery of a higher concentration of steroids with greater specificity, whereas the interlaminar approach has the advantage of providing multilevel spread of the injectate [5]