Lhermitte's sign during lateral cervical puncture: survey of possible accidents in the lateral C1-C2 puncture and report of 2 cases of spinal cord penetration

Lhermitte's sign was referred by two patients during lateral cervical puncture (LCP) due to accidental puncture of the spinal cord; no sequelae were observed in these patients. A brief review of the literature is presented, concerning: 1. Lhermitte's sign; 2. reported accidents during LCP. Avoidance of neural and/or vascular injuries is possible by employing the posterior approach to LCP (puncture of the dorsal spinal subarachnoid space at C1-C2). The lateral suboccipital puncture (at the atlanto-occipital space) of the cisterna magna is also recommended.