Pneumothorax after electromyographic electrode insertion in the paracervical muscles: case report and radiographic analysis.

A patient developed pneumothorax after needle electrode examination of the paracervical muscles. Because such a complication appeared unlikely and had not been reported previously, we studied cadavers and examined cervical spine radiographs to assess the vulnerability of lung tissue to paracervical muscle needle insertion. Radiographs of the cervical spine were used to determine the depth and location of lung tissue. In five of 23 patient radiographs studied, lung tissue extended above the clavicle with a distance from skin surface to lung tissue of approximately 3.3 cm. The electromyographer examining the paracervical musculature should be aware that needle electrode penetration of lung tissue is possible. Examination must be conducted with care, especially in thin patients with long necks. Needle insertion close to the midline is the safest technique.