Transient quadriplegia after fluoroscopic-guided selective cervical nerve root block in a patient who received cervical interbody fusion -A case report-

Abstract

Selective cervical nerve root block is executed for patients who have symptoms of cervical radiculopathy for diagnostic and therapeutic purposes. However several catastrophic complications caused by this procedure have been reported including neurological complications. A 43-year-old male received a C5 selective cervical nerve root block procedure due to continuous radiating pain even after cervical discectomy and interbody fusion was performed. At the time of the procedure, the contrast outline revealed reflux of the nerve root and epidural space. But after the procedure was performed, the patient experienced decreased sensation in the upper and low extremities as well as motor paralysis of both extremities. Our sspecting diagnosis was anterior spinal artery syndrome but both sensory and motor functions were subsequently recovered within a few hours after the procedure was completed. Due to the difficult nature of this case, we reported these complications and reviewed current literature related to this study.

Keywords: Anterior spinal artery syndrome; Intrathecal injection; Paralysis; Spinal nerve root.

Fig. 1

An anterior-posterior view of cervical spine during C5 nerve root injection. The needle lies in the C5-6 intervertebral foramen after injection of 1 ml contrast medium. The needle is not advanced no further than halfway across facet column. The contrast outline shows the nerve root and epidural reflux taking place.