A Whitacre-type spinal needle does not prevent intravascular injection during cervical nerve root injections

South Med J. 2010 Jul;103(7):679-82. doi: 10.1097/SMJ.0b013e3181e1e3d6.

Abstract

We present a case of intravascular injection in a 41-year-old female during cervical selective nerve root injection using a 22-gauge 3.5-inch Whitacre-type pencil-point subarachnoid needle with a curve placed at the distal tip positioned using continual live fluoroscopic guidance. After negative aspiration for blood and cerebrospinal fluid and no elicited paresthesias during the procedure, 1 mL of contrast was injected. Initial imaging at C6 captured the outline of the nerve root along with a significant amount of transient vascular runoff. This case report demonstrates that Whitacre-type spinal needles do not prevent vascular injection, and that aspiration of the needle is not a reliable sign of intravascular injection.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cervical Vertebrae
  • Contrast Media / adverse effects
  • Female
  • Humans
  • Injections, Spinal / adverse effects
  • Injections, Spinal / instrumentation*
  • Intervertebral Disc Displacement / therapy
  • Medical Errors*
  • Needles / adverse effects*
  • Needles / standards
  • Spinal Nerve Roots*

Substances

  • Contrast Media