Ralph Jeffrey W, Malik Rabia, Layzer Robert B
UCSF Medical Center, San Francisco, CA, USA.
Neurohospitalist. 2015 Oct;5(4):212-6. doi: 10.1177/1941874414557080.
Three cases of longitudinally extensive cervical myelopathies temporally associated with neck injections are presented. The spinal cord injury was similar radiographically, despite a number of different needle approaches and substances injected. In recent years, there have been reports of an acute cervical myelopathy immediately following an injection procedure in the neck. Various explanations have been offered for this unfortunate complication, including (1) direct injection into the cord leading to traumatic injury, (2) injection of particulate matter into the arterial supply of the cord causing microvascular embolism and spinal cord infarction, and (3) intraneural injection of the chemical with centripetal spread of the injectant from the nerve trunk to the substance of the cord. The merits of each of these 3 mechanisms in explaining these cases are discussed. Albeit rare, acute cervical myelopathy should be considered a potential complication from any deep injection of chemicals into the neck.
本文报告了3例与颈部注射在时间上相关的纵向广泛颈髓病病例。尽管采用了多种不同的进针方法并注射了不同物质，但脊髓损伤在影像学上表现相似。近年来，有关于颈部注射操作后立即发生急性颈髓病的报道。针对这一不幸并发症提出了各种解释，包括：（1）直接注入脊髓导致创伤性损伤；（2）向脊髓动脉供应中注入颗粒物导致微血管栓塞和脊髓梗死；（3）神经内注射化学物质，注射剂从神经干向脊髓实质向心性扩散。讨论了这三种机制在解释这些病例中的合理性。急性颈髓病虽然罕见，但应被视为颈部任何深部化学物质注射的潜在并发症。
