Symptomatic Pneumorrhachis After Cervical Epidural Steroid Injection Resulting in a Transient Right-Sided Brachial Plexopathy: A Case Report

Sunny Kim, MD, Nicholas Storlie, BA, Kessiena Aya, DO, E. Schroeder, Hamid Abbasi, MD, PhD
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Abstract

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
颈椎硬膜外类固醇注射后出现症状性气痛,导致暂时性右侧臂丛病1例
背景:宫颈硬膜外类固醇注射(CESI)是诊断和治疗各种类型颈椎病理的常用方法。这种手术的严重并发症很少见,但包括硬膜穿刺、硬膜外血肿和空气栓塞。气胸,即椎管中存在空气,被认为是硬膜外麻醉后常见的影像学表现,很少有症状。病例报告:我们报告一名56岁的女性,她在椎板间CESI后出现右上肢麻木和麻痹,随后的影像学显示C6-T3硬膜外间隙空气病变。观察12小时后,患者症状自行消退。结论:该病例显示了一种以前未报道的CESI并发症,这对ESI(硬膜外类固醇注射)的从业人员来说是很重要的。关键词:病例报告,硬膜外类固醇注射,注射,层间,气痛
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