A retrospective study of severe neurological complications after central neuraxial blockades in Sweden from 1990 to 1999 found 127 complications, including spinal hematoma (33), cauda equina syndrome (32), meningitis (29), epidural abscess (13), and miscellaneous (20). Permanent neurologic damage occurred in 85 patients. The incidence of complications after spinal blockade was 1:20,000–30,000, while after obstetric epidural blockade it was 1:25,000. Spinal hematoma after epidural blockade had an incidence of 1:200,000, significantly lower than that in patients undergoing knee arthroplasty (1:3,600). The study found that complications occurred more frequently after epidural blockade than spinal blockade, and the types of complications differed. Obstetric patients had a significantly lower incidence of complications. Osteoporosis was proposed as a previously neglected risk factor. Close surveillance after central neuraxial blockade is essential for safe practice. The study involved a postal survey and administrative files. Information was obtained from 72 departments, with 42 reporting complications. After patient identification, 64 cases were confirmed, and 63 were found in administrative files. The study identified 127 complications, with 73 occurring in the last 5 years of the study period. Most complications were seen in orthopaedic surgery, while few were observed in the large obstetric population. Permanent neurologic damage was observed in 85 patients. The study found that complications after epidural blockade were more common than after spinal blockade, and the complications were different. Obstetric patients had a significantly lower incidence of complications. The study also found that spinal hematoma occurred in 33 patients, with 24 occurring after epidural blockade. Spinal hematoma was more common in females, and the presence of coagulopathy or thromboprophylaxis administered close to the blockade was documented in 11 patients. The study found that spinal hematoma occurred more frequently in patients with spinal stenosis. The study also identified infectious complications, including epidural abscess (13 patients) and meningitis (29 patients). The study found that meningitis occurred after spinal blockade in 24 cases, including one case of combined spinal epidural blockade. The study also identified intracranial subdural hematoma and accidental dural puncture as complications. Traumatic cord lesions were found in nine patients, with difficulties in performing the block in 10 cases. The study concluded that the incidence of severe neurological complications after central neuraxial blockades is higher than previously thought, and that osteoporosis is a significant risk factor. The study emphasized the importance of close surveillance after central neuraxial blockadesA retrospective study of severe neurological complications after central neuraxial blockades in Sweden from 1990 to 1999 found 127 complications, including spinal hematoma (33), cauda equina syndrome (32), meningitis (29), epidural abscess (13), and miscellaneous (20). Permanent neurologic damage occurred in 85 patients. The incidence of complications after spinal blockade was 1:20,000–30,000, while after obstetric epidural blockade it was 1:25,000. Spinal hematoma after epidural blockade had an incidence of 1:200,000, significantly lower than that in patients undergoing knee arthroplasty (1:3,600). The study found that complications occurred more frequently after epidural blockade than spinal blockade, and the types of complications differed. Obstetric patients had a significantly lower incidence of complications. Osteoporosis was proposed as a previously neglected risk factor. Close surveillance after central neuraxial blockade is essential for safe practice. The study involved a postal survey and administrative files. Information was obtained from 72 departments, with 42 reporting complications. After patient identification, 64 cases were confirmed, and 63 were found in administrative files. The study identified 127 complications, with 73 occurring in the last 5 years of the study period. Most complications were seen in orthopaedic surgery, while few were observed in the large obstetric population. Permanent neurologic damage was observed in 85 patients. The study found that complications after epidural blockade were more common than after spinal blockade, and the complications were different. Obstetric patients had a significantly lower incidence of complications. The study also found that spinal hematoma occurred in 33 patients, with 24 occurring after epidural blockade. Spinal hematoma was more common in females, and the presence of coagulopathy or thromboprophylaxis administered close to the blockade was documented in 11 patients. The study found that spinal hematoma occurred more frequently in patients with spinal stenosis. The study also identified infectious complications, including epidural abscess (13 patients) and meningitis (29 patients). The study found that meningitis occurred after spinal blockade in 24 cases, including one case of combined spinal epidural blockade. The study also identified intracranial subdural hematoma and accidental dural puncture as complications. Traumatic cord lesions were found in nine patients, with difficulties in performing the block in 10 cases. The study concluded that the incidence of severe neurological complications after central neuraxial blockades is higher than previously thought, and that osteoporosis is a significant risk factor. The study emphasized the importance of close surveillance after central neuraxial blockades