RESUMEN
Radiofrequency denervation of the cervical medial branches is a possible treatment for chronic cervical facet pain syndrome when conservative management has failed. According to the literature, complications after radiofrequency denervation of the cervical medial branches are rare. We report a case of possible phrenic nerve injury after ipsilateral radiofrequency denervation of the cervical medial branches following a posterolateral approach.
Asunto(s)
Ablación por Catéter/efectos adversos , Plexo Cervical/cirugía , Dolor de Cuello/cirugía , Nervio Frénico/lesiones , Complicaciones Posoperatorias/etiología , Adulto , Ablación por Catéter/métodos , Vértebras Cervicales , Dolor Crónico/cirugía , Comorbilidad , Desnervación/métodos , Femenino , Humanos , Persona de Mediana Edad , Dolor de Cuello/epidemiología , Obesidad/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/epidemiologíaRESUMEN
Cervical radicular pain presents itself as pain radiating from the neck to the arm. If conservative treatment fails, a cervical epidural steroid injection can be considered. A rare but possible complication resulting from the interlaminar approach is unintentional cervical dural puncture that may result in post-dural puncture headache (PDPH). Dural puncture from an interlaminar cervical epidural injection reportedly range from 0.25% to 2.65%. An epidural blood patch is a possible treatment option when conservative treatment fails. Relief could be secondary to 'sealing' of the dural tear from the clotted blood and reestablishment of physiological intracranial pressure. Another theory is an increase in the subarachnoid pressure from the injected blood. The increased pressure may restore normal intracranial pressure. We describe 2 cases of cervical PDPH treated with lumbar epidural blood patch. In 1 case, there was complete resolution of the symptoms and in the other case, there was great improvement of symptoms and a high thoracic blood patch was performed to resolve the remaining headache.