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Lumbar Epidural Injection with Resulting Spinal Hematoma

ID: exh64204a-nl
This stock medical exhibit begins with one sagittal view of the lumbar spine clearly revealing a previous fusion at L4-5, the disc bulge at L3-4 and the retrolisthesis and disc bulge at L5-S1. A box is shown over the L4-5 level to provide an orientation to the following enlargement. Next, an enlarged sagittal view of the L4-5 level is shown providing a more detailed view of the spinal canal. This image clearly reveals the complex vasculature in the spinal canal including numerous small arteries and the complex venous plexus. This image reveals just how vulnerable the vasculature is during a spinal injection. Next, an additional view of the overall lumbar spine is included to illustrate the L4-5 epidural injection. This image shows the gloved hand of a doctor inserting a spinal needle through a the posterior aspects of the spine with the tip piercing down into the epidural space in the spinal canal. Next, an MRI interpretation is included illustrating the subsequent condition, post-epidural injection. This interpretive illustration is mounted beside the actual MRI it's based on. This illustration clearly reveals the large epidural hemorrhage resulting in considerable spinal canal stenosis from L2-3 through L4-5. Finally, one large intra-operative view is included revealing the lumbar spine from a posterior view. This image shows that the lamina has been removed at L3-L4 and partially at L2 and L5. Also shown is a dural tear which developed and was repaired during a previous surgical procedure.

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