Faculty mentor/PI email address

jim010@aol.com

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Keywords

bilateral pneumothorax, branch nerve block, Iatrogenic complications, scoliosis and altered anatomy, post-procedural chest pain

Date of Presentation

5-6-2026 12:00 AM

Poster Abstract

Bilateral pneumothorax is an uncommon but clinically significant complication of thoracic spinal interventions. We report the case of a 20-year-old female with underlying scoliosis who developed acute pleuritic chest pain, dyspnea, and persistent cough immediately following bilateral T2–T5 medial branch nerve block injections performed in an outpatient pain management setting.  Thoracic medial branch blocks are generally considered low-risk procedures; however, the proximity of the pleura to posterior thoracic elements places patients at risk for iatrogenic pleural injury, particularly in individuals with altered spinal anatomy such as scoliosis. This case underscores the importance of maintaining a high index of suspicion for pneumothorax in post-procedural patients presenting with chest pain or dyspnea, even when initial vital signs are reassuring. Early recognition, prompt imaging, and timely intervention remain critical to preventing progression to respiratory compromise.

Disciplines

Medicine and Health Sciences | Musculoskeletal Diseases | Respiratory Tract Diseases

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May 6th, 12:00 AM

Case Report: Bilateral Pneumothorax Following T2–T5 Medial Branch Nerve Block

Bilateral pneumothorax is an uncommon but clinically significant complication of thoracic spinal interventions. We report the case of a 20-year-old female with underlying scoliosis who developed acute pleuritic chest pain, dyspnea, and persistent cough immediately following bilateral T2–T5 medial branch nerve block injections performed in an outpatient pain management setting.  Thoracic medial branch blocks are generally considered low-risk procedures; however, the proximity of the pleura to posterior thoracic elements places patients at risk for iatrogenic pleural injury, particularly in individuals with altered spinal anatomy such as scoliosis. This case underscores the importance of maintaining a high index of suspicion for pneumothorax in post-procedural patients presenting with chest pain or dyspnea, even when initial vital signs are reassuring. Early recognition, prompt imaging, and timely intervention remain critical to preventing progression to respiratory compromise.

 

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