Cervical Myelopathy Caused by Injections into the Neck

Abstract

Three cases of longitudinally extensive cervical myelopathies temporally associated with neck injections are presented. The spinal cord injury was similar radiographically, despite a number of different needle approaches and substances injected. In recent years, there have been reports of an acute cervical myelopathy immediately following an injection procedure in the neck. Various explanations have been offered for this unfortunate complication, including (1) direct injection into the cord leading to traumatic injury, (2) injection of particulate matter into the arterial supply of the cord causing microvascular embolism and spinal cord infarction, and (3) intraneural injection of the chemical with centripetal spread of the injectant from the nerve trunk to the substance of the cord. The merits of each of these 3 mechanisms in explaining these cases are discussed. Albeit rare, acute cervical myelopathy should be considered a potential complication from any deep injection of chemicals into the neck.

Contrast medium injection into the spinal cord

“…Spinal cord complication after the myelography sometimes leads to a serious complication . Three possibilities are considered for this complication: direct contrast medium injection into the spinal cord, spinal cord infarction and centripetal spread of the injected medium from the nerve trunk to the cord . The direct injection is most plausible in this patient, because computed tomography showed a hyperdensity lesion at the lumbar puncture level (conus medullaris).…”