Cord injury after spinal block for caesarean section

The most common causes of nerve injury following regional anaesthesia are compression from haematoma, direct trauma and chemical neuritis.1 We describe a 26-year-old woman who had undergone an emergency caesarean section under spinal anaesthesia for fetal distress (category 1) in a peripheral hospital. The anaesthetist had used a 25-guage needle, while attempting to access the L3-L4 and L4-L5 intervertebral spaces in the midline, with the patient in the left lateral decubitus position. During the needle insertion, the patient experienced severe pain radiating down her right leg. Following the procedure, she developed right foot drop, right leg numbness and dysesthesia in an L4 to S1 dermatomal distribution. Five months after the delivery, the patient was referred to our tertiary centre. On examination, she had severe dorsiflexion weakness of the right foot (Power Medical Research Council (MRC) grade 1/5) with mild weakness of hip internal rotation and abduction, knee flexion…

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