Introduction: Transforaminal epidural steroid injection (TFESI) is a widely used nonsurgical procedure in the treatment of patients with radiculopathy.It is efficacious in relieving pain, but a number of complications are being reported.Recently, increasing frequency of major complications, such as spinal cord infarction and cerebral infarction, has been reported with the use of a particulate steroid within fluoroscopic-guided procedures.
Methods: We report a 49-year-old man with a history of chronic cervical radiculopathy, who experienced a Ball - Batter - Mask devastating complication after TFESI.Results: After 2 min of regular TFESI, the patient abruptly experienced muscle weakness in both upper extremities and within 5 min the patient became Arabic Wall Clock quadriplegic.Despite active rehabilitation, the patient remained bed-ridden 4 years after the catastrophic event.
To our knowledge, this is the first reported case of spinal cord infarction that occurred after TFESI in Korea.Conclusion: Considering the risk of dreadful complications, which appear in an unpredictable manner, TFESI with fluoroscopic guidance should be done only with a nonparticulate steroid.