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#20456

Hello,
I am writing on behalf of a friend. Several months ago, she was diagnosed with a herniated disc and was told a cervical epidural injection. The doctor doing the injection punctured the spinal column causing a fluid leak. A day or two later, the same doctor performed a blood patch, but the amount of blood was too great and it tore open the pin-sized hole. My friend spent several days in the hospital lying flat on her back to heal the tear. After she recovered, she resumed normal activities (the doctors said she could) and a month later the tear re-opened. She then spent several more days in the hospital to heal. Since then, she has experienced tingling in her scalp, pain in her neck, numbness and tingling in her hand. Even the constant jostling even from moderate walking causes pain and discomfort. Shampooing or brushing her hair is painful and she describes the feeling as a “pressure” on her head and neck. By the end of each day the pain is severe. I was wondering if arachnoiditis is something that can occur in the cervical spine area, and if this condition is something that might be causing her pain, or if it is something else. Have you ever encountered symptoms like this in your practice?

[Donald Corenman, MD, DC]

#20458

Having a dural leak after a cervical injection is very unusual but does happen on occasion. The blood patch is a normal solution to this leak and lying down can be helpful (but not as much as if the leak is in the lumbar spine).

Arachnoiditis can occur in the cervical spine but again, this condition is rare in the neck.

What should be considered is a new MRI to look for a leak (called a pseudomeningeocele). If a leak is present, sometime a blood patch along with a diverting drain can solve the problem. A diverting drain takes a measured amount of CSF (cerebrospinal fluid) out of the lumbar spine each hour through a drain placed in the lumbar spine. This drain normally needs to be used for 4 days while the patient stay in a lying down position. Does not sound fun but may be necessary.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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