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Symptomatic Pneumorrhachis After Cervical Epidural Steroid Injection Resulting in a Transient Right-Sided Brachial Plexopathy: A Case Report
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BACKGROUND: Cervical epidural steroid injection (CESI) is a commonly performed procedure for both the diagnostic and therapeutic management of various types of cervical spine pathology. Serious complications from this procedure are rare, but include dural puncture, epidural hematoma, and air embolism. Pneumorrhachis, the presence of air in the spinal canal, is hypothesized to be a common radiological finding following epidural anesthesia that is rarely symptomatic. CASE REPORT: We report the case of a 56-year-old woman who experienced right upper-extremity numbness and paralysis following interlaminar CESI, with subsequent imaging showing an air lesion in the epidural space from C6-T3. The patient’s symptoms resolved spontaneously after 12 hours of observation. CONCLUSIONS: This case demonstrates a previously unreported complication of CESI that is important for practitioners of ESI (epidural steroid injection) to be aware of. KEY WORDS: Case report, epidural steroid injection, injections, interlaminar, pneumorrhachis
American Society of Interventional Pain Physicians
Title: Symptomatic Pneumorrhachis After Cervical Epidural Steroid Injection Resulting in a Transient Right-Sided Brachial Plexopathy: A Case Report
Description:
BACKGROUND: Cervical epidural steroid injection (CESI) is a commonly performed procedure for both the diagnostic and therapeutic management of various types of cervical spine pathology.
Serious complications from this procedure are rare, but include dural puncture, epidural hematoma, and air embolism.
Pneumorrhachis, the presence of air in the spinal canal, is hypothesized to be a common radiological finding following epidural anesthesia that is rarely symptomatic.
CASE REPORT: We report the case of a 56-year-old woman who experienced right upper-extremity numbness and paralysis following interlaminar CESI, with subsequent imaging showing an air lesion in the epidural space from C6-T3.
The patient’s symptoms resolved spontaneously after 12 hours of observation.
CONCLUSIONS: This case demonstrates a previously unreported complication of CESI that is important for practitioners of ESI (epidural steroid injection) to be aware of.
KEY WORDS: Case report, epidural steroid injection, injections, interlaminar, pneumorrhachis.
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