Spinal epidural hematoma occurring at a distance from the transforaminal epidural injection site: A case report.

RATIONALE: Transforaminal epidural steroid injection (TFESI) is a conservative method to treat back pain due to radiculopathy. However, epidural hematoma can occur after the procedure by various mechanisms, which can cause serious complications.

PATIENT CONCERNS: An 82-year-old man with spinal stenosis was treated with TFESI in the right intervertebral foramen at the L2-L3 level. The next morning, he experienced severe back pain and diffuse motor deficit.

DIAGNOSIS: Emergency magnetic resonance imaging revealed fluid collection in the posterior epidural space at the T11-L1 level with central-canal stenosis.

INTERVENTIONS: Emergency hematoma evacuation was performed to remove the epidural hematoma.

OUTCOMES: After the surgery, the back pain disappeared.

LESSONS: Epidural hematoma may occur due to causes other than direct needle injury after TFESI. Therefore, careful observation of the patient is necessary after the procedure.