A sheared Racz catheter in cervical epidural space for thirty months: a case report

Abstract

Percutaneous epidural neuroplasty may lead to complications such as hematoma, infection, epidural abscess, meningitis, hypotension, respiratory depression, urinary and fecal dysfunction, sexual dysfunction and paresthesia. Other technical complications may include shearing or tearing, misplacement, blockage and migration of the catheter. We report a case of a 41-year-old female patient, who underwent surgical removal of a sheared catheter, which was retained for 30 months after cervical Racz neuroplasty.

A Prospective Randomized Comparative Trial of Targeted Steroid Injection Via Epidural Catheter Versus Standard C7-T1 Interlaminar Approach for the Treatment of Unilateral Cervical Radicular Pain

“…The use of a cervical epidural catheter can result in sheering and retention of the catheter tip, yet this complication has only been associated with the use of a stiff catheter. 7,8 The use of a cervical catheter can also result in disruption of the epidural venous plexus with epidural hematoma, yet this has also only been reported in association with the use of a stiff catheter. 8 Furthermore, epidural hematoma is a possible complication of the standard C7-T1 CIESI procedure, 30 with inadequate evidence to suggest that the risk is any different when using a cervical catheter.…”

“…6 As such, safety concerns associated with other techniques are largely mitigated, but specific targeted steroid deposition remains feasible. With regard to potential adverse events with cervical catheter use, cases of shearing and retention of the catheter, 7 dural puncture, 8 and epidural abscess 8 have been reported, but without sequelae, and only with the use of a stiff catheter during neuroplasty rather than a soft catheter CIESI. Complications of CIESI using a soft epidural catheter have yet to be reported.…”