Epidural Anesthesia in Surgery — 29yo Woman | Neurosurgery | SMLE Q#18094
SMLE Question #18094
Surgery
Neurosurgery
Objective: OBJ-310
Last updated: February 2026
A 29-year-old woman presents to the emergency department 7 days after an uncomplicated vaginal delivery with epidural anesthesia. She has progressively worsening severe low back pain, fever, new bilateral leg weakness with difficulty walking, urinary retention, and decreased anal sphincter tone. Neurologic examination shows 3/5 strength in both lower extremities and reduced perianal sensation. MRI of the lumbar spine shows a posterior epidural rim-enhancing fluid collection compressing the thecal sac, with cauda equina compression. What is the most appropriate next step in management?
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