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A Whitacre-type spinal needle does not prevent intravascular injection during cervical nerve root injections

We present a case of intravascular injection in a 41-year-old female during cervical selective nerve root injection using a 22-gauge 3.5-inch Whitacre-type pencil-point subarachnoid needle with a curve placed at the distal tip positioned using continual live fluoroscopic guidance. After negative aspiration for blood and cerebrospinal fluid and no elicited paresthesias during the procedure, 1 mL of contrast was injected. Initial imaging at C6 captured the outline of the nerve root along with a significant amount of transient vascular runoff. This case report demonstrates that Whitacre-type spinal needles do not prevent vascular injection, and that aspiration of the needle is not a reliable sign of intravascular injection

Keywords : Adult,adverse effects,blood,Cervical Vertebrae,Contrast Media,Female,Humans,Injections,Injections,Spinal,instrumentation,Intervertebral Disc Displacement,Medical Errors,Needles,Paresthesia,Spinal Nerve Roots,standards,therapy,, Whitacretype,Spinal,Needle,Does,Not, pain in diaphragm when breathing

Date of Publication : 2010 Jul

Authors : Candido KD;Ghaly RF;Mackerley S;Knezevic NN;

Organisation : Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA. kdcandido@yahoo.com

Journal of Publication : South Med J

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/20531058

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