An Osteoporotic Vertebral Fracture Case After Lumbar Sympathetic Ganglion Block

Abstract

We report the case of a patient with lymphedema who experienced an osteoporotic vertebral fracture following lumbar sympathetic ganglion block (LSGB). A 66-year-old woman with intractable lymphedema of the right leg went through surgery for cervix cancer. Because she was resistant to conventional treatments, we planned to commence LSGB treatment. Thus, she received two sessions of LSGB administered with a steroid and local anesthetic mixture. After the second session, the patient underwent severe lumbar pain. After thorough anamnesis and physical examination, we decided to use magnetic resonance imaging to rule out the possibility of metastasis. Contrast-enhanced magnetic resonance imaging, which was assessed by an expert spine radiologist, revealed an osteoporotic fracture of the L4 vertebra. The patient’s severe pain considerably diminished in the third month after beginning antiosteoporotic and analgesic medications, orthosis, and exercises. We speculate that the use of steroids in LSGB may lead to osteoporotic vertebral fracture.

Keywords

• low back pain
• lymphedema
• osteoporotic fracture
• sympathetic ganglion
• steroids