Somayaji H S, Saifuddin A, Casey A T H, Briggs T W R
Department of Orthopaedic Surgery, The Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, Middlesex, United Kingdom.
Spine (Phila Pa 1976). 2005 Feb 15;30(4):E106-8. doi: 10.1097/01.brs.0000153400.67526.07.
Case report.
To report a rare case of spinal cord infarction following therapeutic computed tomography-guided nerve root injection.
Diagnostic and therapeutic image-guided nerve root injection is commonly performed in the management of low back pain and sciatica. The severe complication of spinal cord infarction has been reported in only 3 cases previously.
Retrospective review of case records and imaging.
A 71-year-old woman presented with symptoms and signs of left L2 nerve root compression. She was managed with computed tomography-guided left L2 nerve root injection using bupivacaine and triamcinolone and developed immediate bilateral sensory loss and paraplegia. Magnetic resonance imaging demonstrated diffuse hyperintensity within the distal thoracic cord and conus on T2-weighted images, consistent with spinal cord infarction.
We report the fourth case of spinal cord infarction following nerve root injection. The severity of this complication warrants that it should be considered during patient consent for this procedure.
病例报告。
报告1例治疗性计算机断层扫描引导下神经根注射后发生脊髓梗死的罕见病例。
诊断性和治疗性影像引导下神经根注射常用于治疗腰痛和坐骨神经痛。此前仅报道过3例脊髓梗死这一严重并发症。
回顾性查阅病例记录及影像学资料。
一名71岁女性出现左侧L2神经根受压的症状和体征。她接受了计算机断层扫描引导下使用布比卡因和曲安奈德进行的左侧L2神经根注射治疗,随后立即出现双侧感觉丧失和截瘫。磁共振成像显示在T2加权图像上胸段脊髓远端和圆锥内弥漫性高信号,符合脊髓梗死表现。
我们报告了第4例神经根注射后发生脊髓梗死的病例。该并发症的严重性表明,在患者签署该手术同意书时应考虑到这一点。