Adverse central nervous system sequelae after selective transforaminal block: the role of corticosteroids

The Spine Journal : Official Journal of the North American Spine Society
Robert L TisoKaren Whalen

Abstract

Selective transforaminal epidural injections are frequently employed in the treatment of pain emanating from the spine. Complication rates are typically low and include paresthesia, hematoma, epidural abscess, meningitis, arachnoiditis and inadvertent subdural or subarachnoid injection. Persistent paraplegia after lumbar transforaminal block has been recently reported. Undetected intra-arterial injection has been implicated as a possible cause. We present a case of massive cerebellar infarction after uneventful selective cervical transforaminal block. Intra-arterial injection of corticosteroid is implicated with focus on particulate size of compound versus blood vessel dimension. Light microscopic data are presented to confirm the potential for embolic vascular occlusion. Case report; light microscopic data. A patient underwent selective transforaminal block on the right at the C5-C6 level. There was C5-C6 disc herniation documented by magnetic resonance imaging and C6 radiculopathy by electromyographic studies. Patient follow-up from medical office records. Needle placement at the C5-C6 foramen on the right was confirmed by biplanar fluoroscopy and injection of contrast medium. Frequent heme-negative aspirations were documente...Continue Reading

References

Jan 1, 1974·Progress in Biophysics and Molecular Biology·R H Kay
Nov 1, 2003·The Spine Journal : Official Journal of the North American Spine Society·John K Houten, Thomas J Errico

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Citations

Jan 23, 2010·Radiology·Humberto G Rosas, Louis A Gilula
Dec 18, 2013·Current Pain and Headache Reports·Laxmaiah ManchikantiHoward S Smith
Sep 21, 2013·Cardiovascular and Interventional Radiology·Martin H MaurerFlorian Streitparth
Oct 1, 2013·Journal of Neuroradiology. Journal De Neuroradiologie·John T WaldKent R Thielen
Aug 31, 2010·AJNR. American Journal of Neuroradiology·T WolterC Hader
Sep 24, 2011·AJNR. American Journal of Neuroradiology·P J MacMahonE C Kavanagh
Dec 31, 2011·AJNR. American Journal of Neuroradiology·J T WaldK R Thielen
May 27, 2009·Current Reviews in Musculoskeletal Medicine·Bradly S GoodmanMatt Bayazitoglu
Apr 24, 2007·AJR. American Journal of Roentgenology·Marc A WallaceParviz Baghai
Dec 13, 2005·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Leif AnderbergMårten Annertz
Jan 15, 2013·Current Pain and Headache Reports·Kenneth D Candido, Nebojsa 'nick' Knezevic
Jun 23, 2010·American Journal of Physical Medicine & Rehabilitation·Benoy BennyDean Briones
Oct 13, 2006·European Radiology·Fouad FayadMichel Revel
Jul 4, 2009·Regional Anesthesia and Pain Medicine·Samer N NarouzeNagy Mekhail
Apr 27, 2011·Regional Anesthesia and Pain Medicine·José M Hernández-GarcíaJosé A De Andrés
Apr 20, 2013·Regional Anesthesia and Pain Medicine·Steven P CohenJames P Rathmell
Apr 1, 2005·Journal of Spinal Disorders & Techniques·Mihnea Dumitrescu, Charles Aprill
Nov 1, 2007·Journal of Spinal Disorders & Techniques·Hoondo KimMyung-Ho Kim
Feb 27, 2008·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Richard DerbyChang-Hyung Lee
Nov 20, 2013·PM & R : the Journal of Injury, Function, and Rehabilitation·David O'BrienDavid J Kennedy
May 23, 2006·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Paul DreyfussNikolai Bogduk
Oct 8, 2014·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Jae Hee Woo, Hahck Soo Park
May 11, 2013·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·William Jeremy BeckworthBaohua Wu
Dec 7, 2013·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Andrew EngelUNKNOWN Standards Division of the International Spine Intervention Society
Jan 25, 2012·PM & R : the Journal of Injury, Function, and Rehabilitation·Daniel LeungAnthony E Chiodo
Dec 31, 2015·Drugs in R&D·Ippokratis PountosPeter V Giannoudis
Aug 10, 2010·The Spine Journal : Official Journal of the North American Spine Society·Matthew SmuckChristopher T Plastaras

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