Gluteal biopolymer injections can migrate unpredictably into the lumbosacral region, creating potential barriers to neuraxial anesthesia and risking contamination of neuraxial structures. We report a case of successful epidural anesthesia in a 32-year-old primigravida with magnetic resonance imaging (MRI)–confirmed biopolymer migration to L5–S1. An epidural was placed at L1–L2 under ultrasound guidance during labor and subsequently used uneventfully for cesarean delivery. This case demonstrates that neuraxial anesthesia may be feasible when imaging is used to identify safe procedural sites and highlights the importance of preprocedural planning to optimize maternal and neonatal outcomes in patients with migrated biopolymers.
Mullins et al. (Wed,) studied this question.