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Penetration of a cervical radicular artery during a transforaminal epidural injection.

BACKGROUND
Inadvertent cannulation or penetration of the cervical radicular arteries during cervical transformaminal epidural injections (TFESIs) is a serious clinical risk, and purportedly, the cause of possible spinal cord injury sustained during this procedure.


CASE
Here, we present a case of inadvertent intravascular penetration of a cervical radicular artery during a C5-6 TFESI and demonstrate the best image capture to date of direct ramification of a cervical radicular artery into the anterior spinal artery.


CONCLUSION
This observation reinforces the need for contrast injection and real-time digital subtraction fluoroscopy during cervical TFESIs for the prevention of spinal cord injury and fatalities.