Paraspinal muscle hematoma after electromyography

There have been few reports of complications related to electromyography. Needle examination of certain muscles is sometimes avoided in patients taking anticoagulant agents, although no clear guidelines have been established. We describe a patient who was not receiving an anticoagulant and developed a large paraspinal muscle hematoma after routine electromyography. Subsequently, all patients who underwent paraspinal muscle electromyography and were diagnosed with radiculopathy at our institution over a 14-month period were reviewed. From this group, 17 patients were identified who had also underwent MRI of the appropriate spinal levels within 1 week after the needle examination. These images were reviewed for evidence of paraspinal muscle hematomas. Four small hematomas were identified in four different patients. None of these were radiologically significant compared with the large hematoma described in the case report. Radiologically apparent paraspinal hematomas after electromyography are an unusual complication of needle examination and do not appear to have any clinical significance. Nevertheless, the presence of these lesions justifies caution when considering electromyography of paraspinal and other deeper muscles in anticoagulated patients.