A Whitacre-type spinal needle does not prevent intravascular injection during cervical nerve root injections.
We present a case of intravascular injection in a 41-year-old female during cervical selective nerve root injection using a 22-gauge 3.5-inch Whitacre-type pencil-point subarachnoid needle with a curve placed at the distal tip positioned using continual live fluoroscopic guidance. After negative aspiration for blood and cerebrospinal fluid and no elicited paresthesias during the procedure, 1 mL of contrast was injected. Initial imaging at C6 captured the outline of the nerve root along with a significant amount of transient vascular runoff. This case report demonstrates that Whitacre-type spinal needles do not prevent vascular injection, and that aspiration of the needle is not a reliable sign of intravascular injection.
Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA. kdcandido@yahoo.com
Kenneth D
KD
Candido
Ramsis F
RF
Ghaly
Sara
S
Mackerley
Nebojsa Nick
NN
Knezevic
D000328:Adult; D002574:Cervical Vertebrae; D003287:Contrast Media / Q000009:adverse effects; D005260:Female; D006801:Humans; D007278:Injections, Spinal / Q000009:adverse effects / Q000295:instrumentation*; D007405:Intervertebral Disc Displacement / Q000628:therapy; D019300:Medical Errors; D009339:Needles / Q000009:adverse effects* / Q000592:standards; D013126:Spinal Nerve Roots
D003287:Contrast Media