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. 2015 Oct;5(4):212-6.
doi: 10.1177/1941874414557080.

Cervical Myelopathy Caused by Injections into the Neck

Jeffrey W Ralph  1 , Rabia Malik  1 , Robert B Layzer  1
Affiliations

Cervical Myelopathy Caused by Injections into the Neck

Jeffrey W Ralph et al. Neurohospitalist. 2015 Oct.

Abstract

Three cases of longitudinally extensive cervical myelopathies temporally associated with neck injections are presented. The spinal cord injury was similar radiographically, despite a number of different needle approaches and substances injected. In recent years, there have been reports of an acute cervical myelopathy immediately following an injection procedure in the neck. Various explanations have been offered for this unfortunate complication, including (1) direct injection into the cord leading to traumatic injury, (2) injection of particulate matter into the arterial supply of the cord causing microvascular embolism and spinal cord infarction, and (3) intraneural injection of the chemical with centripetal spread of the injectant from the nerve trunk to the substance of the cord. The merits of each of these 3 mechanisms in explaining these cases are discussed. Albeit rare, acute cervical myelopathy should be considered a potential complication from any deep injection of chemicals into the neck.

Keywords: EMG/nerve conduction velocity; brachial plexus neuropathies; neuromuscular diseases; spinal cord diseases; spinal cord injuries; techniques.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Cervical magnetic resonance imaging (MRI) with sagittal T2-weighted sequence demonstrating a linear hyperintensity from C3 to C7. Axial image (inset) shows abnormal signal in the right paracentral cord (arrow).
Figure 2.
Figure 2.
Cervical magnetic resonance imaging (MRI) pre (A) and post (B) cervical injection demonstrating development of a T2-hyperintense lesion from C2 to C6. Selected axial images (right panel) demonstrating involvement of the left central and dorsal aspect of the cord at C2, C4, and C5, top to bottom, respectively.
See this image and copyright information in PMC

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