Computed tomography-guided cervical selective transforaminal epidural block for a patient with bilateral anatomical variations of vertebral artery -a case report-

Hoon Jung, Jung A. Lim, Ki Bum Park, Seong Wook Hong, Kyung Hwa Kwak, Jun Mo Park

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

A 56-year-old woman complained of radiating pain to the left arm. She was diagnosed with left-sided foraminal stenosis at the C5-6 level. Te neurosurgeon requested a left C6 cervical selective transforaminal epidural block (CSTE). Cervical MRI showed a left-sided large tortuous vertebral artery (VA) at the C5-6 level. Before performing CSTE, a CT angio-gram was carried out and showed bilateral tortuous VAs. To minimize adverse events, CSTE was performed with non-particulated steroids and under CT guidance. Following the procedure, the patient's symptoms were relieved completely. Although complication rates of CSTE are generally low, if it occurs, disastrous situation could be. Additionally, if the patient has anatomical variations, the possibility of a complication occurring is greatly increased. It is therefore important to determine whether the patient has any anatomical variations of the VA before performing procedures such as CSTE, and to ensure that needle placement is correct during the procedure and an appropriate drug, such as a non-particulated steroid, is selected.

Original languageEnglish
Pages (from-to)468-472
Number of pages5
JournalKorean Journal of Anesthesiology
Volume65
Issue number5
DOIs
StatePublished - Nov 2013

Keywords

  • Injections
  • Steroids
  • Vertebral artery

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