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Air Myelopathy Following a Cervical Epidural Injection


  • Disclosures: Dr. Sonal Mehta reports no disclosures; Dr. Al-Amin Khalil reports no disclosures; and Dr. Amer Alshekhlee reports no disclosures.

Sonal Mehta, MD, Neurologic Institute, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106, USA. Tel: 216-235-3497; Fax: 216-844-5066; E-mail:


Background and Purpose.  Epidural injections are commonly utilized procedure in pain clinics; these procedures are not without complications. We present a rare air entrapment within the substance of the spinal cord causing symptoms of myelopathy.

Methods.  Report of a case.

Results.  A 56-year-old woman with chronic cervical pain underwent an elective cervical epidural injection. A small amount of Lidocaine was injected at the left cervical 7 to test needle patency; she immediately complained of severe cervical pain radiated to the left upper and lower extremities. The procedure was immediately terminated and needle was removed. Post-operative neurological examination revealed mild left lower extremity weakness and left hemiataxia. An immediate MRI of the cervical spine showed an air bubble within the cervical spinal cord that has resolved on the following imaging. The clinical syndrome also completely resolved.

Conclusion.  Although rare, epidural cervical injection can be complicated by air myelopathy.