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Spinal cord injury by direct damage during trigger point injection: a case report
Jong Bum Kim1, Min Cheol Chang1
1Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
The Journal of International Medical Research
|May 4, 2021
Summary
Trigger point injection (TPI) can cause rare spinal cord injury (SCI). This case highlights the risk of iatrogenic SCI during paraspinal TPI, emphasizing the need for careful technique and potential imaging guidance.
Area of Science:
- Neurology
- Pain Management
- Interventional Pain Medicine
Background:
- Trigger point injection (TPI) is a common treatment for myofascial pain syndrome.
- While generally safe, TPI carries potential complications such as bleeding, hematoma, and infection.
Observation:
- A 59-year-old woman developed symptoms of spinal cord injury (SCI) after receiving blind TPI in the thoracolumbar paraspinal muscles.
- She reported immediate electric shock sensations, followed by significant lower extremity weakness and neuropathic pain.
Findings:
- Thoracolumbar MRI revealed spinal cord edema in the T12-L2 region, consistent with TPI-induced injury.
- Electrophysiological studies confirmed a lack of motor conduction in the affected leg.
- Partial motor recovery and reduced pain were noted at 7 months post-procedure.
Implications:
- This case underscores the risk of iatrogenic SCI from paraspinal TPI.
- Clinicians should exercise caution and consider imaging guidance for accurate needle placement.
- Awareness of this rare complication is crucial for patient safety in myofascial pain management.
