Pneumomyelia Secondary to Interlaminar Cervical Epidural Injection Causing Acute Cord Injury with Transient Quadriparesis

2020 ◽  
Vol 143 ◽  
pp. 434-439
Author(s):  
Kamil W. Nowicki ◽  
Jenna R. Gale ◽  
Vikas Agarwal ◽  
Edward A. Monaco
2008 ◽  
Vol 33 (4) ◽  
pp. 377-379 ◽  
Author(s):  
Jae-Hyun Lee ◽  
Jung-Kil Lee ◽  
Bo-Ra Seo ◽  
Sung-Jun Moon ◽  
Jae-Hyoo Kim ◽  
...  

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Xirzat Abdukeram ◽  
Muhtar Rixit ◽  
Dilare Mahmut

PURPOSE: To investigate the feasibility and clinical efficacy of ozone in the treatment of spinal cord injury so as to restore the function and sensation of the limbs. METHODS: From May 2007 to July 2016, 82 patients with spinal cord injury were treated, including 24 females and 58 males, with an average age of 32.1 years. Among all the research, 26 cases of cervical spinal cord injury, 12 cases of paraplegia in the thoracic spinal cord, 44 cases of paraplegia in the lumbar spine, all of whom had muscle strength 0 and had incontinence. Frankel classification, grade A is 69 cases, B class is 13 cases. 12 cases of spinous process wire fixation was performed; in 61 cases, internal pedicle screw fixation, and no internal fixation was required in 9 cases. In these patients, we did epidural injection of 2-8 mL of ozone at 35 mcrg/mL with the C arm. In 4 cases we did spinal canal decompression and internal fixation and we used an epidural catheter into the epidural and subarachnoid cavity to directly inject 2-8 mL of ozone at 35 mcrg/mL; after catheter withdrawal, we did ozone injection in the scar segment with the C arm to increase acurracy of the technique. RESULTS: In 10 patients, the treatment produced no neurological improvement; the remaining 72 patients, from the 3rd postoperative day, feeling started to recover. We observed 22 patients during 26 months that could stand up and walk with crutches and 18 patients of them could control defecation and 16 patients could feel the defecation; 14 cases could do slight activities with their lower extremities; 12 patients reached mild forearm movement. CONCLUSION: The key to the repair of the injured spinal cord is provided through the axon growth; ozone can play a worthy role in the release of scar and allow nerve axons to grow and access some function recovery.


2014 ◽  
Vol 6;17 (6;12) ◽  
pp. E761-E767
Author(s):  
Sayed E. Wahezi

Interlaminar cervical epidural steroid injections (ic-ESI) are safe and effective treatment options for the management of acute and chronic radiculopathy, spinal stenosis, and other causes of neck pain not responding to more conservative measures. However, the procedure inherently lends itself to possible spinal cord injury (SCI). Though reports of such events have been documented, the clinical presentation of patients with needle puncture SCI varies. In part, this may be due to anatomic considerations, as symptoms may be dependent on the cervical level intruded, as well as the volume and type of injectate used. Many cases go unreported and therefore the true incidence of cord injections during ic-ESI is not known. Cervical epidurals can be performed by the transforaminal or interlaminar approach. It is generally accepted that ic-ESI is safer than transforaminal epidurals. There are numerous reports of arterial invasion or irritation with the latter despite an inherently greater risk of cord puncture with the former. The likelihood of cord interruption rises when ic-ESIs are performed above C6-C7 as there is a relatively slim epidural layer compared to lower cervical epidural zones. Though most cases of devastating outcomes, such as hemiplegia and death, have been reported during cervical transforaminal epidural injections and rarely with ic-ESI, it is important to understand the symptoms and potential pitfalls of performing any cervical epidural injection. Cervical epidural malpractice claims are uncommon, but exceed those of steroid blocks at all the levels combined, demonstrating the need for improved awareness of potential complications in ic-ESI. Here, we will describe an unusual presentation of a spinal cord injection during an ic-ESI procedure. Key words: Cervical epidural, spinal cord, hemiparesis


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