• Pain Med · Feb 2010

    Case Reports

    Penetration of a cervical radicular artery during a transforaminal epidural injection.

    • Paul Verrills, Gillian Nowesenitz, and Adele Barnard.
    • Metro Spinal Clinic, Melbourne, Victoria, Australia.
    • Pain Med. 2010 Feb 1;11(2):229-31.

    BackgroundInadvertent 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.CaseHere, 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.ConclusionThis 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.

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