Spinal Cord Injury During Attempted Cervical Interlaminar Epidural Injection of Steroids

Area of Science:

• Interventional Pain Medicine
• Neurology
• Radiology

Background:

• Interlaminar cervical epidural injections are a common interventional pain medicine procedure.
• Spinal cord injury is a rare but known complication of these injections.
• Previous literature has rarely reported or illustrated this specific complication.

Observation:

• This case details an inadvertent injection of contrast medium directly into the cervical spinal cord.
• The procedure deviated significantly from established published guidelines for interlaminar cervical epidural injections.
• The first oblique fluoroscopic image of an intramedullary injection is presented.

Findings:

• Deviation from best practice guidelines increases the risk of preventable complications.
• Intramedullary injection represents a serious deviation from safe procedural technique.
• Accurate imaging and adherence to anatomical landmarks are crucial.

Implications:

• Recognizing and understanding potential complications is vital for patient safety.
• Strict adherence to established practice guidelines can minimize the incidence of iatrogenic spinal cord injury.
• This case underscores the need for continuous education and vigilance in interventional pain procedures.