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Needle Cervical Root Stimulation May Be Complicated by Pneumothorax

It is possible to stimulate cervical nerve roots by inserting a monopolar needle electrode into the cervical paraspinal musculature lateral to the C5-C6 or C7-T1 interspaces. [1,2] The needle is advanced until the vertebral arch is reached, and then electrical stimulation is applied. We report a case of pneumothorax associated with this procedure and offer suggestions to minimize the likelihood of this complication.

A 65-year-old petite woman with a previously biopsied left brachial plexus schwannoma was being evaluated preoperatively for evidence of brachial plexus dysfunction. Physical examination was unremarkable except for a palpable mass in the supraclavicular fossa. A CT confirmed this mass (Figure 1). Nerve conduction values were normal, including motor and sensory nerve conduction of the median, ulnar, and radial nerves, sensory nerve conduction of the lateral antebrachial cutaneous nerve, and F-wave studies. Cervical root stimulation was …