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Background: Spinal cord compression secondary to nerve root hypertrophy is often attributed to hereditary neuropathies. However, to avoid misdiagnosis, rare immune-mediated neuropathy such as chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) should not be overlooked. This report presents a case of multilevel nerve root hypertrophy leading to significant cord compression from CIDP. Case Description: We report a 56-year-old gentleman with type two diabetes mellitus who presented with subacute cervical cord syndrome following a fall. Mixed upper and lower motor neuron features were noted on examination. Magnetic resonance imaging showed significant pan-spinal proximal nerve root hypertrophy, compressing the cervical spinal cord. Initial radiological opinion raised the possibility of neurofibromatosis type 1 (NF-1), but neurophysiology revealed both axonal and demyelinating changes that were etiologically non-specific. C6 root and sural nerve biopsies taken at cervical decompression displayed striking features suggestive for CIDP. Although NF-1 is the most observed condition associated with root hypertrophy, other important and potentially treatable differentials need to be entertained. Conclusion: While rare, CIDP can cause significant spinal cord compression. Furthermore, clinical manifestations of CIDP can mimic those of inherited peripheral neuropathies. Neurologists and neurosurgeons should be aware of this condition to optimize subsequent therapeutic decision-making.

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Aim: This paper is to determine the incidence of COVID-19 infection and severe symptoms following spinal steroid injections for pain control. Methodology: This a retrospective observational study based in the department of neurosurgery, Salford Royal Foundation Trust. Study period is from March 23rd, 2020 till December 31st, 2020. 222 patients had these injections during the time period. Data was collected by telephonic interview and online questionnaire. Data was analyzed to find out how many of the people who received steroid injection got COVID infection and how many had severe infection. It was then compared with local infection rates. Results: Out of 222 patients found, 130 patients opted to take part in the survey. Six patients among them had tested positive after the injection and two more patients had symptoms of COVID who have been considered to be positive. Overall, 6.15% of patients who received steroid injections had positive COVID-19 results. 3.85% patients had the infection within 3 months of injection. One patient (0.77%) needed hospital admission due to COVID. The incidence of COVID during this time period in Salford was 6.17% and rate of hospital admission due to COVID was 0.77%. Conclusion: The rate of COVID-19 infection after steroid injection are lower than the local incidence of COVID in Salford during that time period and equivalent to the rate of hospital admission due to COVID. This suggests that a steroid injection in the spine for pain management does not increase the incidence of COVID or cause severe infections.