Successful transforaminal epidural blood patch in a patient with multilevel spinal fusion
| Autor: | Hanwool Ryan Choi, Michael M. Bottros, Benjamin Fuller |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Anesthesia
Epidural Epidural Space Male medicine.medical_specialty Post-dural-puncture headache medicine.medical_treatment law.invention law Back pain medicine Humans Electrode placement Epidural blood patch business.industry General Medicine Spinal cord stimulator Epidural space Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure Spinal Fusion Spinal fusion Needle insertion medicine.symptom Post-Dural Puncture Headache business Blood Patch Epidural |
| Zdroj: | Regional anesthesia and pain medicine. 45(9) |
| ISSN: | 1532-8651 |
| Popis: | IntroductionEpidural blood patch (EBP) is a vital tool in treating postdural puncture headache (PDPH). Traditional interlaminar epidural needle insertion into the epidural space, however, may be challenging due to anatomical variations. As an alternative method, we successfully performed an EBP via transforaminal approach.Case reportA mid-50-year-old male patient with multilevel spinal fusion developed PDPH after a failed spinal cord stimulator electrode placement. A transforaminal EBP was carried out by injecting a total of 8 mL of autologous blood into the neuroforamen at the L1–L2 level bilaterally. Our patient’s positional headache resolved immediately after the procedure.DiscussionTo our knowledge, this is the first case reported of a transforaminal EBP in a patient with diffuse epidural adhesive fibrosis secondary to multilevel laminectomies and spinal fusion. This case report highlights potential risks and benefits of this novel technique and also discusses its therapeutic mechanism of action. We believe that a transforaminal EBP should be considered in patients who are poor candidates for the traditional interlaminar EBP. |
| Databáze: | OpenAIRE |
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