Unlabelled: We report a case of brainstem infarction following a C5-C6 cervical transforaminal injection, a rare and serious neurological complication of this procedure. Cervical transforaminal steroid injection is a common therapy for patients with persistent cervical radiculopathy not relieved by conservative treatment, and is effective in 65-70% of cases. Unfortunately, this procedure may lead to serious complications such as neurological damage. These complications are rare but potentially fatal, as reported in our case. Complications could be due to three mechanisms: the technique itself, the cervical vascular anatomy and the properties of the product (corticoids). The neurological complications can be diagnosed through brain MRI. This case report focuses on the importance of a risk/benefit evaluation when performing this medical procedure.
Learning Points: Physicians should be better informed about severe complications following cervical transforaminal epidural steroid injections and their strict indications.Severe adverse events are rare but they can be disastrous.Non-particulate corticosteroid should be used.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6438116 | PMC |
| http://dx.doi.org/10.12890/2019_001082 | DOI Listing |
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Article Synopsis
- Cervical radiculopathies are typically treated with nerve root injections, and this study introduces a new ultrasound-guided technique for better visualization and injection accuracy.
- A 56-year-old patient with chronic C6 radiculopathy received treatment using this method, combining 5% dextrose and vitamin B12, which significantly improved their symptoms.
- The new technique ensures precise needle placement and effective medication spread while minimizing risks and reducing the need for fluoroscopy, lowering radiation exposure and enhancing treatment outcomes.
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