What would you do at this point?

Here is what we did: 

an MRI was requested, and the epidural catheter had to be removed per MRI protocol and epidural catheter manufacture recommendation in order to safely obtain the scan. The catheter’ wire-reinforced portion may potentially move in the magnetic field of the MRI. The catheter was removed, and an MRI was obtained. According to the radiologist, the MRI demonstrated a lumbar 3-4 level epidural hematoma, which was causing posterior mass-effect and indentation on the ventral nerve roots, measuring approximately 9 mm AP x 9 mm TR x 19 mm AP. A small rim of T2 hypointensity was seen around this lesion, suggesting hemorrhagic products. Axial T2-weighted images demonstrated moderate to severe central canal stenosis with deformation of the thecal sac and probable compression on the descending nerve roots. There was effacement of the lateral recesses at this level with probable impingement on the traversing L3 nerve root. [click here for Initial MRI]

Spine surgery was consulted. Since there were no neurological deficits, the patient was closely monitored during the rest of her hospitalization. She received a neurological exam hourly. This included lower extremity sensorimotor function, symptoms of back pain exacerbation, as well as assessment for bowel or bladder incontinence. A follow-up MRI three days afterward showed a significant interval decrease in size of the lumbar epidural hematoma. The patient was discharged on post-operative day seven without any neurological compromise from the hematoma. [click here for Initial MRI]

INITIAL MRI:

FOLLOW UP MRI