Unusual complication after combined spinal/epidural anaesthesia

Abstract

An 31-year-old women with a long history of back pain without neurological symptoms underwent a caesarean section during the 36th week of pregnancy with combined spinal-epidural anaesthesia. Indication was the increasingly severe back pain. She delivered a normal healthy boy. On the 3rd day after surgery she developed a discrete sensory cauda equina syndrome on the left side. The interpretation of the magnetic resonance imaging (MRI) was a tumor in the thecal sac extending from the middle of the vertebral body of L-1 to the the superior vertebral plate of L-3. A few days later she underwent a laminectomy under general anaesthesia with resection of an intradural mass adherent to the cauda equina. Pathological review of the surgical specimen revealed a myxopapillary ependymoma WHO grade I. The postoperative course was uncomplicated with preservation of bladder dysfunction but after 4 weeks the bladder function was normalised.