| 18F-045 |
Acute Cervical Myelopathy with Quadriparesis after Cervical Transforaminal Epidural Blocks
Department of Anesthesiology and Pain Medicine, College of Medicine, Inha University, Incheon, South Korea1
Background: Cervical transforaminal epidural blocks(TFEBs) have been postulated to be more effective than cervical interlaminar epidural blocks(ILEB) because transforaminal epidural blocks can deliver the injections accurately to the site of pathology. However, many studies have reported that serious complications following TFEBs occurred more frequently when it was conducted at the cervical level. We report a case of cervical myelopathy and left arm paralysis after TFEBs in a patient with cervical spinal stenosis.
Case: The patient is 63 years old woman, 62.1 kg, 151.3 cm, BMI 27.1 without any history of trauma or disease. She suffered from paresthesia in the C5,6,7 sensory dermatomes and radiating pain. She suffered from weakness and numbness of the left side extremity immediately during TFEBs. A magnetic resonance image(MRI) was obtained and demonstrated intramedullary high signal intensity is seen at left sided spinal cord from C4 to T4 with ill-defined edema and myelopathy(Fig. 1). Conventional conservative care was allowed for the treatment her weakness and neuropathic pain. Although the motor weakness of her left arm recovered sufficiently for casual activity, the neurologic symptom in her left hand remained uncomfortable for nearly 8 months, regardless of treatment. In follow-up MRI, 8months after spinal cord injury, was obtained and demonstrated decrease size intramedullary high signal intensity(Fig. 2). she had recovery except of grasp, first and second finger abduction weakness and intermittent paresthesia in the hand.
Case: The patient is 63 years old woman, 62.1 kg, 151.3 cm, BMI 27.1 without any history of trauma or disease. She suffered from paresthesia in the C5,6,7 sensory dermatomes and radiating pain. She suffered from weakness and numbness of the left side extremity immediately during TFEBs. A magnetic resonance image(MRI) was obtained and demonstrated intramedullary high signal intensity is seen at left sided spinal cord from C4 to T4 with ill-defined edema and myelopathy(Fig. 1). Conventional conservative care was allowed for the treatment her weakness and neuropathic pain. Although the motor weakness of her left arm recovered sufficiently for casual activity, the neurologic symptom in her left hand remained uncomfortable for nearly 8 months, regardless of treatment. In follow-up MRI, 8months after spinal cord injury, was obtained and demonstrated decrease size intramedullary high signal intensity(Fig. 2). she had recovery except of grasp, first and second finger abduction weakness and intermittent paresthesia in the hand.
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