Air Myelopathy Following a Cervical Epidural Injection

Abstract

Background and Purpose. Epidural injections are commonly utilized procedure in pain clinics; these procedures are not without complications. We present a rare air entrapment within the substance of the spinal cord causing symptoms of myelopathy.Methods. Report of a case.Results. A 56-year-old woman with chronic cervical pain underwent an elective cervical epidural injection. A small amount of Lidocaine was injected at the left cervical 7 to test needle patency; she immediately complained of severe cervical pain radiated to the left upper and lower extremities. The procedure was immediately terminated and needle was removed. Post-operative neurological examination revealed mild left lower extremity weakness and left hemiataxia. An immediate MRI of the cervical spine showed an air bubble within the cervical spinal cord that has resolved on the following imaging. The clinical syndrome also completely resolved.Conclusion. Although rare, epidural cervical injection can be complicated by air myelopathy. © 2010 Wiley Periodicals, Inc.