Paraplegia Following Spinal-Epidural Anesthesia in Lumber Canal Stenosis: A Case Report

Background: Paraplegia following neuroaxial block is one of the rare complication a severe form of cauda equina syndrome. Reporting such rare cases is essential for continuing medical education. We are presenting a case report of post epidural complete paraplegia in a patient with severe spinal canal stenosis. Case presentation: A 51-year-old female presented to our clinic on post operative day 2 with complete paraplegia following a bilateral total knee replacement surgery under spinal epidural anesthesia done elsewhere in the city. Epidural catheter was removed on POD 1 till then two top-ups were given and anticoagulants (Inj. enoxaparin 40mg sc once a day) were started on postoperative day 1, while mechanical anticoagulation was started immediately in post operative period. Patient was started on steroids and when no recovery could be documented L1 to L5 central decompression was performed on POD 9. Recovery was not significant. Conclusion: Menifestations of cauda equina syndrome might get accentuated to varying severity following a neuroaxial blockade in a patient with already compromised canal. Preanesthetic identification of such cases should be considered, and appropriate anaesthetic precautions should be undertaken, prompt identification and appropriate management of these complications should be considered for fruitful outcome.