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KMID : 0356920130650050468
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Korean Journal of Anesthesiology
2013 Volume.65 No. 5 p.468 ~ p.472
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Computed tomography-guided cervical selective transforaminal epidural block for a patient with bilateral anatomical variations of vertebral artery -a case report-
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Jung Hoon
Lim Jung-A
Park Ki-Bum
Hong Seong-Wook
Kwak Kyung-Hwa
Park Jun-Mo
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Abstract
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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. The 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 angiogram 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.
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KEYWORD
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Injections, Steroids, Vertebral artery
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