Complications following injection of sclerosing agent to precipitate fibro-osseous proliferation.

Abstract

MONOGRAPH was published in 19562 purporting to show that chronic low backache is in many instances the result of relaxation of the ligaments about the joints of the spine and pelvis. Treatment by the injection of an irritating solution consisting of the sodium salt of a vegetableoil fatty acid, similar to that employed in the injection and treatment of varicose veins, was recommended. This treatment is alleged to produce proliferation of fibrous tissue and bone, thereby stabilizing the involved joints. Four thousand injections were reported, with no unfavorable incident or sequelae. Complete relief of symptoms was reported in 90 per cent of the patients treated. There have been two recent reports of complications following this treatment. Schneider et al. ~ reported the case of a 50year-old woman with intermittent attacks of low-back pain and sciatica for 15 years. Severe pain and paraplegia developed at the time of injection of sclerosing solution into the lumbar region. The paraplegia improved, but severe hydrocephalus developed about 3 months later. At operation a markedly adhesive arachnoiditis was found about the rim of the cisterna magna. The patient expired a few hours after the procedure. At autopsy inflammatory changes were found at the base of the brain in the posterior fossa and the upper cervical spinal cord. There was perivascular infiltration about the major blood vessels and the choroid plexus. The brain was edematous. There was subependymal gliosis, with astroglial prolifera-