Document Detail


Cervical epidural injection complicated by syrinx formation: a case report.
MedLine Citation:
PMID:  20461029     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Case report and review of literature. OBJECTIVE: Review the common side-effects of interlaminar cervical epidural injection (CEI) and to report a novel complication of this procedure. SUMMARY OF BACKGROUND AND DATA: CEIs are commonly used to treat chronic radicular neck pain. Several minor and major complications have been reported in literature. We report a rare complication of syrinx formation resulting from a CEI. METHODS: A 52-year-old woman presented from an outside hospital after undergoing a CEI. Under fluoroscopic guidance, an epidural needle was inserted at C7-T1 level. Radiologic contrast showed appropriate epidural spread. Shortly after waking up from the procedure, the patient complained of inability to move her right arm and leg, numbness of her right hemibody below the neck, and urinary retention. RESULTS: Magnetic resonance imaging of the spine revealed a syrinx extending from the C1 to T4 levels. There was no evidence of epidural collection or blood. CONCLUSION: Interlaminar CEI is thought to be a relatively safe procedure. Spinal cord injury is a documented complication of spinal anesthesia at any level of the spinal cord, even with fluoroscopic guidance, but most complications are thought to be minor and transient in nature. Syrinx formation with focal myelomalacia following spinal anesthesia has been reported in the lumbar area Pradhan et al, J Neurol Sci 2006;251:70-2, but we know of no existing reports involving the cervical region. We report this rare complication in this case report.
Authors:
Sara Khan; Erik P Pioro
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Spine     Volume:  35     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-31     Completed Date:  2010-09-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E614-6     Citation Subset:  IM    
Affiliation:
Cleveland Clinic, Neurological Institute, Cleveland, OH 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Cervical Vertebrae*
Female
Humans
Injections, Epidural / adverse effects
Middle Aged
Syringomyelia / diagnosis*,  etiology,  physiopathology*

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