Severe and Long-Lasting Complications of the Nerve Root and Spinal Cord After Central Neuraxial Blockade

In Brief BACKGROUND: Although rare, major complications after spinal and epidural anesthesia do occur. We report the complications after central neuraxial blockade occurring in 2000 in France. METHODS: A retrospective questionnaire study was sent to all French rehabilitation centers to detail severe and long-lasting neurologic complications after central neuraxial blockade. RESULTS: All specialized and 44% of the nonspecialized centers answered. Twelve cases, nine women and three men, were noted, 60% of which involved patients over 50 yr of age. All patients still had neurological deficits after 3 mo. Seven received spinal anesthesia, four had epidural anesthesia, and one had both procedures. Hemorrhagic lesions were found in only three patients. Among the nine other patients, anatomic abnormalities were common, including five instances of lumbar canal stenosis and two with spinal arachnoid cysts. CONCLUSIONS: These findings suggest the influence of underlying spinal conditions in these complications. IMPLICATIONS: Severe, secondary neurologic complications of central neuraxial blockade observed in rehabilitation centers in France are often associated with underlying spinal conditions, particularly lumbar canal stenosis and arachnoid cyst.