Anterior spinal artery syndrome following total hip arthroplasty under epidural anaesthesia

We present a ease of anterior spinal artery syndrome in a 57-year-old man having a total hip arthroplasty under epidural anaesthesia. Epidural insertion and surgery were uneventful. Postoperatively bilateral lower limb motor weakness was attributed to the initial dose of local anaesthetic. There was no change in neurological status 24 hours later. Magnetic resonance imaging demonstrated spinal cord infarction. The diagnosis of anterior spinal artery syndrome was made based on the patient's neurological condition and MRI findings.