| 제목 |
A Unusual Complication of Sacral nerve root Injury Following Harvesting Bonemarrow : A Case Report |
| 소속 |
Kyungpook National University Medical Center, Department of Rehabilitation Medicine1, Kyungpook National University Hospital, Department of Rehabilitation Medicine2 |
| 저자 |
Tae-Woo Nam1*, Won-Jong Yang1, Jae-Eun Lee2, Seung-Hwan Jung2, Jong-Moon Hwang2, Tae-Du Jung1† |
Rationale
Hematopoietic stem cell transplantation(HSCT) represents an important therapeutic option for many hematologic disease. Many studies showed the complication of recipient after Hematopoietic stem cell transplantation(HSCT). However, complications of harvesting bonemarrow are rare and rarely can cause sacral root injury.
Patient concerns
An 26-year-old man was admitted to our medical center because he complained of acute onset painful burning and tingling sensation at the left posterior thigh and calf. The pain score on the Visual Analogue Scale(VAS) varied from 7/10 to 8/10. He underwent a bonemarrow harvesting procedure two days before the hospitalization as a bonemarrow donor, using both posterior superior iliac spine(PSIS) as a puncture site at the supine position.
Diagnoses
Pelvic MRI showed enhancement around the left S2 nerve root in T1-weighted images. He was examined nerve conduction study and electromyography after 3 weeks later from the admission. Nerve conduction studies revealed normal conduction velocity and amplitude on both lower extremity. Electromyography presents abnormal spontaneous potential and neurogenic motor unit potentials on the S2-innervated intrinsic foot muscle at the left.
Interventions
He was treated with analgesics for pain control. Lyrica(Pregabalin)
Outcomes
The patient was followed up after 3 and 6 months. Neuropathic pain improved to Visual Analogue Scale(VAS) 3/10, and recovery state was confirmed by reinnervation patterns of motor unit potentials in electromyography.
Lessons
Accurate anatomical knowledge and carefulness are required to avoid the sacral nerve root injury when performing the bonemarrow harvesting procedure.
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Fig 1. Puncture site of bonemarrow harvesiting. The patient underwent bonemarrow harvesting through posterior superior iliac spine(PSIS).
Fig 2. MRI of pelvis-The axial(T1 weighted-left, T2-weighted-right) views show the signal change with enhancement at left S2 nerve root.
Table 1. Electromyography findings of patients
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