Percutaneous lumbar epidural adhesiolysis is widely used a treatment for various chronic spinal pain but inadvertent complications of subdural, spinal, or intravascular injection can occur. We report a case of 63-year-old female with unusual pulsatile subdural injection image during attempted lumbar epidural adhesiolysis with fluoroscopy. Pulsatile image confined to the posterior aspect of the spinal canal at L3-4 level was observed. After recognizing subdural injection, we performed epidural adhesiolysis carefully without using steroid and local anesthetics under fluoroscopic guidance. Although unusual, pain physician needed to the understanding of the various subdural fluoroscopic contrast images.

Introduction
 Case report
 Discussion
 References

• Hyun Young Lee(Department of Anesthesiology and Pain Medicine, Chosun University School of Medicine, Gwangju, Korea, Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju, Korea)
• Kyung Joon Lim(Department of Anesthesiology and Pain Medicine, Chosun University School of Medicine, Gwangju, Korea, Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju, Korea) Corresponding author
• In Gook Jee(Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju, Korea)
• Byung Sik Yu(Department of Anesthesiology and Pain Medicine, Chosun University School of Medicine, Gwangju, Korea, Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju, Korea)
• Soo Young Park(Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju, Korea)