Penetration of a cervical radicular artery during a transforaminal epidural injection.
BACKGROUND
Inadvertent cannulation or penetration of the cervical radicular arteries during cervical transformaminal epidural injections (TFESIs) is a serious clinical risk, and purportedly, the cause of possible spinal cord injury sustained during this procedure.


METHODS
Here, we present a case of inadvertent intravascular penetration of a cervical radicular artery during a C5-6 TFESI and demonstrate the best image capture to date of direct ramification of a cervical radicular artery into the anterior spinal artery.


CONCLUSIONS
This observation reinforces the need for contrast injection and real-time digital subtraction fluoroscopy during cervical TFESIs for the prevention of spinal cord injury and fatalities.
Verrills
Paul
P
Metro Spinal Clinic, Melbourne, Victoria, Australia.
Nowesenitz
Gillian
G
Barnard
Adele
A
D015360:Analgesia, Epidural / Q000009:adverse effects*; D000792:Angiography; D001158:Arteries / Q000293:injuries*; D002574:Cervical Vertebrae / Q000098:blood supply / Q000473:pathology; D005471:Fluoroscopy; D006801:Humans; D007267:Injections / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000188:drug therapy*; D011843:Radiculopathy / Q000150:complications / Q000473:pathology; D012039:Regional Blood Flow; D020069:Shoulder Pain / Q000188:drug therapy*; D013256:Steroids / Q000008:administration & dosage / Q000627:therapeutic use
D013256:Steroids