Iatrogenic cervical spinal cord injury after interlaminar cervical epidural injection
Chabra, Ranjeev Maung, Chun Pazionis, Theresa Habibi, Behnum
Chabra, Ranjeev
Maung, Chun
Pazionis, Theresa
Habibi, Behnum
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Journal article
Date
2023-11-02
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Physical Medicine and Rehabilitation
Orthopaedic Surgery and Sports Medicine
Orthopaedic Surgery and Sports Medicine
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https://doi.org/10.1016/j.inpm.2023.100288
Abstract
Objectives: Describe a catastrophic complication of cervical epidural injection (CEI) in a patient with prior anterior cervical discectomy with fusion (ACDF). Setting: Interlaminar CEI at C7-T1 was performed under minimal sedation. Discussion: Right hemiparesis, diffuse dysesthesia, and tactile allodynia were immediately described after the procedure. 24 hours after CEI, an MRI showed an increased T2 signal and decreased T1 signal in the spinal cord extending from C3-T3. Postsurgical ACDF changes, cervicovertebral ligament anomalies, repetitive microtrauma from serial CEI's, and epidural space compromise may have complicated the loss of resistance technique and increased the risk for dural puncture and intrinsic cord injury. Conclusion: Knowledge of cervical spinal anatomy, biomechanical implications of ACDF, ligamentous inflammation, pre-operative image review, and perioperative patient feedback are valuable insights that may mitigate the risk of severe adverse events.
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Citation
Ranjeev Chabra, Chun Maung, Theresa Pazionis, Behnum Habibi, Iatrogenic cervical spinal cord injury after interlaminar cervical epidural injection, Interventional Pain Medicine, Volume 2, Issue 4, 2023, 100288, ISSN 2772-5944, https://doi.org/10.1016/j.inpm.2023.100288.
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Elsevier
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Interventional Pain Medicine, Vol. 2, Iss. 4
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