Spinal Cord Injury and Postdural Puncture Headache following Cervical Interlaminar Epidural Steroid Injection: A Case Report

Medicina, 2022 · DOI: 10.3390/medicina58091237 · Published: September 7, 2022

Anesthesiology Neurology Pain Management

Simple Explanation

A 35-year-old woman experienced complications after a cervical interlaminar epidural steroid injection (CIESI) for neck pain, resulting in spinal cord injury and a postdural puncture headache. The patient's symptoms included dizziness, decreased blood pressure, motor weakness, and sensory loss immediately after the CIESI procedure. Despite conservative treatment, some neurological deficits persisted for six months, highlighting the risks associated with CIESI procedures.

Study Duration

6 Months

Participants

A 35-year-old woman

Evidence Level

Level 4, Case Report

Key Findings

1
Fluoroscopy does not guarantee the prevention of spinal cord penetration during CIESI procedures.
2
Persistent neurological deficits, such as decreased finger abduction and sensory loss, can occur following CIESI, even with conservative treatment.
3
CIESI at the C5/6 level may pose a higher risk of spinal cord injury compared to C6/7 or C7/T1 levels due to the anatomical structure of the cervical spine.

Research Summary

This case report describes a spinal cord injury following cervical interlaminar epidural steroid injection (CIESI) in a 35-year-old woman, highlighting potential risks and complications associated with the procedure. The patient experienced immediate neurological symptoms and postdural puncture headache (PDPH) after the CIESI, leading to the diagnosis of spinal cord injury via MRI. The authors recommend performing CIESI at C6/7 or C7/T1 levels, where the epidural space is relatively larger, to mitigate the risk of spinal cord injury, and emphasize the importance of understanding potential risks.

Practical Implications

Risk Mitigation

Performing CIESI at C6/7 or C7/T1 levels could reduce the risk of spinal cord injury.

Patient Monitoring

Close monitoring and communication with patients during CIESI is crucial to detect early signs of complications.

Treatment Protocols

Prompt diagnosis and initiation of steroid pulse therapy may help improve neurological outcomes following spinal cord injury during CIESI.

Spinal Cord Injury and Postdural Puncture Headache following Cervical Interlaminar Epidural Steroid Injection: A Case Report

Simple Explanation

Key Findings

Research Summary

Practical Implications

Risk Mitigation

Patient Monitoring

Treatment Protocols

Study Limitations

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Spinal Cord Injury and Postdural Puncture Headache following Cervical Interlaminar Epidural Steroid Injection: A Case Report

Simple Explanation

Key Findings

Research Summary

Practical Implications

Risk Mitigation

Patient Monitoring

Treatment Protocols

Study Limitations

Your Feedback

Was this summary helpful?