Are Cervical Nerve Root Blocks “Safe and Effective”?
Wagner (1) reported on the use of CT fluoroscopy to guide cervical nerve root blocks (CNRB). He detailed the technique and described the initial experience at his institution. He concluded that CT fluoroscopy is a safe and effective alternative during CNRB. We want to emphasize the serious complications associated with CNRB. Five well-documented cases of catastrophic neurologic complications following CNRB have been reported recently in the literature (2 6). Other publications have alluded to several other unreported cases. Described injuries include brain stem and midbrain hemorrhage, massive cerebellar infarct, occipital cerebral edema, and 2 cases of anterior spinal artery syndrome. Four of the reported patients died as a result of the injuries, and 1 had permanent neurologic sequelae. The exact mechanism of central nervous system injury following CNRB is not known. In the case reports citing complications following CNRB, a standard technique of radiologic guidance with radiocontras
