Use of a 22-gauge Whitacre needle to reduce the incidence of side effects after lumbar myelography: a prospective randomised study comparing Whitacre and Quincke spinal needles.
In a prospective study lumbar iohexol myelography was performed in 107 consecutive patients, randomised for lumbar puncture with a Quincke or Whitacre spinal needle. All patients answered a questionnaire about possible side effects. Data from 100 patients (58 men, 42 women) were evaluated. In the Quincke group (n = 53), 23 (43%) reported no side effects. In the 30 patients who reported various side effects, post-dural puncture headache (PDPH) occurred in 22 (42%), of whom 9 had mild, 6 moderate and 7 (13%) severe cephalalgia, 18 (34%) reported increased low back pain/sciatica, 5 nausea and 7 dizziness. In the Whitacre group (n = 47), 33 (70%) had no side effects. PDPH was reported by 9 patients (19%), of whom 2 had mild, 6 moderate and only 1 (2%) severe cephalalgia, 4 (9%) reported increased low back pain/sciatica, 5 nausea and 4 dizziness. The conclusion drawn from this study is that lumbar myelography performed with the Whitacre spinal needle reduces postspinal side effects.
Pedersen
O N
ON
Department of Radiology, Aust-Agder Central Hospital, Arendal, Norway.
D000328:Adult; D000368:Aged; D003287:Contrast Media; D004244:Dizziness / Q000209:etiology; D004388:Dura Mater; D004867:Equipment Design; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D015994:Incidence; D007472:Iohexol; D017116:Low Back Pain / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009192:Myelography / Q000009:adverse effects / Q000295:instrumentation*; D009325:Nausea / Q000209:etiology; D009339:Needles / Q000009:adverse effects; D011446:Prospective Studies; D012585:Sciatica / Q000209:etiology; D013129:Spinal Puncture / Q000009:adverse effects / Q000295:instrumentation*
D003287:Contrast Media; D007472:Iohexol