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Abstract

1. 2022;6;271-276 A Rare Calcified Complication of Epidural Injections for Lumbar Spinal Stenosis: A Case Presentation and Literature Review
   Case Report
   Carl-Elie Majdalani, MD, Christopher Mares, MD, Daniel Shedid, MD, and Sung-Joo Yuh, MD.

BACKGROUND: Neurogenic claudication secondary to degenerative lumbar stenosis is typically managed with nonsurgical options, such as epidural corticosteroid injections. As a standard and effective treatment for lumbar stenosis, clinicians must be aware of the corticosteroids choice when injecting in the epidural space.

CASE REPORT: A 62-year-old man presenting with sciatic pain is treated with multiple neuroforaminal, facet, and caudal corticoid injections over the course of several months without any symptomatic resolution. A magnetic resonance imaging of his lumbar spine revealed focal bilateral central stenosis at the L4-L5 level. A computed tomography revealed hyperdense lesions at that level. The patient was referred for a surgical option. He underwent complete minimally invasive resection of the bilateral lesion with instrumented and interbody fusion. The final pathology report identified the mass as a calcified granuloma.

CONCLUSIONS: Following repetitive methylprednisolone acetate injections, one must be aware of all the potential complications arising from particulate corticosteroids.

KEY WORDS: Spinal stenosis, epidural injections, granulomas, corticosteroids

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