Spinal Cord Injury by Direct Damage During CT-Guided C7 Transforaminal Epidural Steroid Injection: A Case Report

Abstract Cervical transforaminal epidural steroid injection (TFESI) under the guidance of computed tomography (CT) can offer great anatomical resolution and precise needle placement in the axial plane. However, some complications, including blood pressure surge, allergic reactions, vasovagal syncope, and cerebral infarct, have been reported after CT-guided cervical TFESI. We report the first case of iatrogenic spinal cord injury (SCI) during a CT-guided cervical TFESI. A 67-year-old woman, upon receiving TFESI on Lt. C7, experienced an electrical shock-like sensation throughout the body. The patient complained of weakness in the left upper and lower extremities (manual muscle testing grade: 2–4) and neuropathic pain (numeric rating scale: 9) in the left upper and lower extremities. Cervical magnetic resonance imaging (MRI) performed 9 days after TFESI showed a high T2 signal at the left side of the spinal cord from levels C5 to C7, and an electrophysiological study performed 14 days after TFESI revealed corresponding findings with cervical MRI. Three months after finishing treatment with a high dose of intravenous methylprednisolone, the patient's motor weakness improved, but it did not recover fully. Correspondence: Min Cheol Chang, Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University 317-1, Daemyungdong, Namku, Daegu, 705-717, Republic of Korea (e-mail: wheel633@gmail.com) Disclaimer statements Contributors None. Funding No funding was received. Conflict of interest declaration: The author declares no conflict of interest. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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