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Intravascular uptake during fluoroscopically guided cervical interlaminar steroid injection at C6-7: a case report

We report 4 cases of intravascular venous uptake of contrast material during fluoroscopically guided cervical interlaminar epidural steroid injection at the C6-7 level. The blood vessel probably involved is the posterior internal vertebral venous plexus, which drains the interlaminar space and returns blood to the right atrium through the paired vertebral veins and right and left brachiocephalic veins. In all 4 cases, intravascular uptake occurred despite negative aspiration of blood before the contrast material was injected. All patients were successfully injected at the C7-T1 level. We recommend the use of fluoroscopic guidance and the injection of contrast to identify potential placement of the injection needle within the vascular space. Potential complications of intravascular venous uptake of contrast material and steroid solution are discussed

Keywords : administration & dosage,Adult,adverse effects,blood,Cervical Vertebrae,complications,Contrast Media,diagnostic imaging,drug therapy,Extravasation of Diagnostic and Therapeutic Materials,Female,Fluoroscopy,Follow-Up Studies,Humans,Injections,Epidural,Male,methods,Middle Aged,Patients,rehabilitation,Risk Assessment,Sampling Studies,Sensitivity and Specificity,Spinal Stenosis,Steroids,, Uptake,During,Fluoroscopically,Guided,Cervical, pain in diaphragm when breathing

Date of Publication : 2008 Mar

Authors : Kaplan MS;Cunniff J;Cooke J;Collins JG;

Organisation : Department of Orthopaedics and Physical Rehabilitation, Worcester, MA 01605-2982, USA. MarkSKaplanMD@comcast.net

Journal of Publication : Arch Phys Med Rehabil

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/18295636

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