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Temporary neurologic deficit after cervical transforaminal injection of local anesthetic
Michael Karasek1, Nikolai Bogduk
1Northwest Spine Group, Eugene, Oregon, USA.
Objective:
To describe the effects of spinal cord block after injection of local anesthetic into a cervical radicular artery.
Design:
Case report.
Setting:
Neurology practice specializing in spinal pain. Interventions. A patient underwent a C6-7 transforaminal injection. Contrast medium indicated correct and safe placement of the needle.
Results:
After the injection of local anesthetic, the patient developed quadriplegia. The injection was terminated. The neurologic impairment resolved after 20 minutes observation.
Conclusion:
Despite correct placement of the needle for a cervical transforaminal injection, injectate may nevertheless enter a cervical radicular artery. Whereas local anesthetic, so injected, appears to have only a temporary effect on spinal cord function, particulate steroids may act as an embolus and cause permanent impairment.
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