Temporary neurologic deficit after cervical transforaminal injection of local anesthetic

Objective. To describe the effects of spinal cord block after injection of local anesthetic into a cervical radicular artery. Design. Case report. Setting. Neurology practice specializing in spinal pain. Interventions. A patient underwent a C6-7 transforaminal injection. Contrast medium indicated correct and safe placement of the needle. Results. After the injection of local anesthetic, the patient developed quadriplegia. The injection was terminated. The neurologic impairment resolved after 20 minutes observation. Conclusion. Despite correct placement of the needle for a cervical transforaminal injection, injectate may nevertheless enter a cervical radicular artery. Whereas local anesthetic, so injected, appears to have only a temporary effect on spinal cord function, particulate steroids may act as an embolus and cause permanent impairment.