Table 7 Clinical information on patients with other serious neurological complications.
Case number | Gender(F/M), age (yrs) | Past history and comorbidities | Surgery type | Anesthesia | Comments anesthesia/analgesia | Symptoms | Complication | Radiography | Recovery result | Medical appraisal and compensation |
|---|---|---|---|---|---|---|---|---|---|---|
1 | M,30 | Neuraxial anesthesia | Cesarean delivery | SA, L2-3 | Uneventful puncture | Numbness and pain in both lower extremity | Conus spinal injury | MRI: T12-L1 spinal cord injury | PMAI: left foot weakness and difficulty walk | Yes |
2 | M,28 | Neuraxial anesthesia | Cesarean delivery | CSEA, L3-4 | Uneventful puncture, epidural analgesia | weakness in left lower extremity | Anterior spinal artery syndrome | MRI: L5/S1 disc degeneration and herniation | PMII | Yes but no compensation |
3 | M,47 | No | appendectomy | CSEA, L2-3 | Uneventful puncture, epidural analgesia | No sensation in left foot, unable to walk | Anterior spinal artery syndrome | MRI: L3/4, L4/5, L5/S1 disc herniation and spinal demyelination | PMAI: numbness and weakness in left lower extremity, can’t walk | Yes |
4 | M,75 | Hypertension | Exploratory laparotomy | CEA, T9-10 | Uneventful puncture, epidural analgesia | Lumber back pain, limb weakness | Epidural hematoma | MRI: T2-T8 extramedullary occupation: epidural hematoma with spinal cord compression and edema | PMII: operative treatment | No |
5 | F,32 | Ankylosing spondylitis | Double J tube placement for renal calculi | CSEA, L3-4 | Difficult puncture with five spinal attempts, electric sensation during puncture, epidural analgesia | High paraplegia, endotracheal intubation | Epidural hematoma | MRI: C2-L1 epidural hematoma | PMAI | No |
6 | F, 74 | No | Prostate tumor biopsy | CSEA, L2-3 | Uneventful puncture | Pain in lower back and left lower extremity, decreased muscle strength in the left lower extremity, hypoesthesia of the right lower extremity | Epidural hematoma | MRI: Abnormal signal shadow behind the spinal canal of T10-L3, epidural hematoma suspected; Herniated discs in T8/9 to L5/S1 | After conservative: PMII | No |
7 | F, 68 | No | TURP | CEA, L2-3 | Difficult puncture twice | Pain in the lumbosacral region is excruciating | Epidural hematoma | After operation: recover | No | |
8 | F, 64 | No | Ureteroscopic lithotripsy | CSEA, L2-3 | Uneventful puncture | Hypoesthesia and motor deficits of lower limb, Incontinence | Epidural hematoma | epidural hematoma, about 6mm*5mm in size | After conservative: PMII | Yes but no compensation |
9 | M,32 | No | 6 h labor analgesia followed by a cesarean delivery | CSEA, L3-4 | Uneventful puncture, epidural analgesia | Urinary incontinence, numbness and weakness in left lower extremity | Cauda equina syndrome | CT: no abnormal | Recover | Yes but no compensation |
10 | M,31 | No | Cesarean delivery | CSEA, L2-3 | electric sensation during puncture, epidural analgesia | weakness in left lower extremity and unable to walk | Cauda equina syndrome | NA | PMII | No |
11 | M,32 | No | Cesarean delivery | CSEA, L3-4 | Uneventful puncture, epidural analgesia | Perianal numbness, difficulty urinating and defecating | Cauda equina syndrome | MRI: no abnormal | PMII | Yes |
12 | M,64 | No | Lower extremity internal fixation removal operation | CEA, L2-3, attempt | Difficult puncture three times, CEA failed, instead of GA | Weakness and sensory disturbance in both lower extremity | Cauda equina syndrome | NA | Recover | No |
13 | M,28 | No | Cesarean delivery | CSEA, L3-4 | Uneventful puncture, epidural analgesia | Incontinent of urine and feces, no sensation and strength in right lower extremity, numbness and weakness in left | Cauda equina syndrome | MRI: no abnormal | PMAI: unable to walk, still incontinent | Yes |
14 | M,42 | Neuraxial anesthesia | Cesarean delivery | CSEA, L2-3 | Uneventful puncture, epidural analgesia | Weakness in both lower extremity | Cauda equina syndrome | CT: lumbar hyperosteogeny | Recover | No |
15 | M,38 | Diabetes | 4.5 h labor analgesia followed by cesarean delivery | CSEA, L3-4 | Uneventful puncture, epidural analgesia | Incontinence of urine and feces, numbness of lower limbs (and weakness), buttocks and perineum | Cauda equina syndrome | MRI: no abnormal | PMAI: numb hips, lack of perineal feeling, weak bladder and bowel control | No |
16 | M,38 | No | Cesarean delivery | CSEA, L3-4 | Uneventful puncture, epidural analgesia | No sensation and strength in lower extremities | Cauda equina syndrome | MRI: no abnormal | PMAI: numbness and weakness in lower extremities | Yes |
17 | M,30 | No | Cesarean delivery | CSEA, L3-4 | electric sensation during puncture, epidural analgesia | Incontinence of urine and feces, paralysis | Cauda equina syndrome | CT: L4-5, L5-S1 disc herniation, MRI: suggested no spinal injury, possible injury to the left sciatic nerve | PMAI: normal muscle strength of lower extremities, weak control of urine and feces | No |
18 | M, 28 | No | Cesarean delivery | CSEA, L2-3 | Uneventful puncture, epidural analgesia | Weakness in both lower extremity | Cauda equina syndrome | MRI: no abnormal | PMII | Yes but no compensation |
19 | M, 26 | Pregnancy-induced hypertension syndrome | Cesarean delivery | CSEA, L3-4 | Patient obesity, Epidural puncture three times, epidural analgesia | Intestinal obstruction, urinary retention, numbness in both lower limbs | Cauda equina syndrome | MRI: no abnormal | Recover | No |
20 | No | Open reduction and internal fixation of femoral fracture | CSEA, L3-4 | Uneventful puncture, epidural analgesia | Numbness in perineal, dysuria | Cauda equina syndrome | MRI: no abnormal | PMAI: Poor control of stool and urine | Yes but no compensation | |
21 | No | Cesarean delivery | CSEA, L3-4 | Uneventful puncture, epidural analgesia | Numbness in the lumbosacral and perineal region, urinary and fecal incontinence, loss of sensation below the knees in both legs, muscle strength rated at 0–1 | cauda equina syndrome | MRI: no abnormal | PMAI: Weakness of both legs | No |
