Case Report| Volume 15, ISSUE 3, e9-e13, March 01, 2015

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Three cases of hemiplegia after cervical paraspinal muscle needling

  • Gyu Yeul Ji
    Depatment of Neurosurgery, Spine and Spinal Cord Research Institute, Yonsei University, College of Medicne, 50 Yonsei-ro, Seodamun-gu, 120-752 Seoul, Korea

    Department of Neurosurgery, Guro Teun Teun Hospital, 547 Siheungdae-ro, Guro-gu, 152-880 Seoul, Korea
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  • Chang Hyun Oh
    Department of Neurosurgery, Guro Teun Teun Hospital, 547 Siheungdae-ro, Guro-gu, 152-880 Seoul, Korea
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  • Won-Seok Choi
    Department of Neurosurgery, Guro Teun Teun Hospital, 547 Siheungdae-ro, Guro-gu, 152-880 Seoul, Korea
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  • Jang-Bo Lee
    Corresponding author. Department of Neurosurgery, Korea University Anam Hospital, College of Medicine, Inchon-ro 73, Seongbuk-gu, Seoul 136-705, Republic of Korea. Tel.: +82-2-920-5729; fax: +82-2-929-0629.
    Department of Neurosurgery, Korea University Anam Hospital, College of Medicine, 73, Inchon-ro, Seongbuk-gu, 136-705 Seoul, Korea
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Published:November 14, 2014DOI:


      Background context

      Muscle needling therapy is common for chronic pain management, but the development of unusual complications such as hemiplegia is not well understood.


      We report on three cases with hemiplegia after cervical paraspinal muscle needling and propose possible explanations for these unusual complications.

      Study design

      Case report.


      The authors retrospectively reviewed the medical charts from a decade (2002-2013) at Korea University Hospital. The records were systematically searched, and the cases with hemiplegia (grade<3) after needing therapy were collected. No conflict of interest reported. No funding received.


      A 54-year-old woman, a 38-year-old woman, and a 60-year-old man with hemiplegia by cervical subdural or epidural hematoma after cervical posterior paraspinal muscle needling without direct invasion (intramuscular stimulation, acupuncture, or intramuscular lidocaine) were observed. All patients were taken for emergent decompressive laminectomy, and their postoperative motor function improved substantially.


      Spinal hematoma after muscle needling is unusual but was thought to result after a rupture of the epidural or subarachnoid veins by a sharp increase in blood pressure delivered in the intraabdominal or intrathoracic areas after needling therapy.


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