ReviewJournal of medical case reports2026
Lumbar epidural haematoma after acupuncture: a case report and review of the literature.
Review in Journal of medical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAcupuncture is widely used for lumbar pain, yet needle-related spinal epidural haematoma (SEH) remains a rarely reported but potentially catastrophic complication. The lumbar segment is often assumed to be a "safe" needling zone, and the true incidence, mechanistic basis and preventive strategy for iatrogenic SEH are poorly defined. CASE PRESENTATION: An 80-year-old Chinese man developed progressive right lumbosciatalgia 10 days after three sessions of electro-acupuncture and a right L5-S1 paravertebral nerve block. Pre-intervention CT had shown no epidural collection; repeat imaging revealed a 3 cm organised haematoma compressing the thecal sac. Formal WHO-UMC causality assessment rated the event 'Probable' iatrogenic, though competing causality with the nerve block cannot be fully excluded. He underwent urgent L5-S1 laminectomy, clot evacuation and cement-augmented pedicle-screw fixation, with complete neurological recovery at 3 months.
conclusionThis case, together with a systematic review of seven similar reports, establishes a clear clinical pathway: repeated lumbosacral needling-venous wall trauma-organised haematoma-nerve-root compression. Key preventive measures include pre-procedure MRI in high-risk subjects, careful individualization of needle depth and electro-acupuncture parameters based on patient anatomy and clinical context. Advanced age and spinal degeneration are not surgical contraindications; timely decompression restores function even after prolonged compression.
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