Transforaminal cervical blood patch for the treatment of post-dural puncture headache.
A 40-yr-old woman received a series of three interlaminar epidural steroid injections for the treatment of axial neck pain secondary to degenerative disc disease. Immediately after her third injection, she experienced symptoms of a dural puncture-induced headache. This headache persisted on a daily basis for 3 mos, despite two epidural blood patches using an interlaminar approach, which was finally completely abated with a transforaminal blood patch. The headache was immediately relieved and remained alleviated through the follow-up interval of 1 yr. In this patient, a fluoroscopically guided transforaminal epidural blood patch proved to be more effective than the classic blind interlaminar approach in the treatment of post-dural puncture headache.
Slipman
Curtis W
CW
Penn Spine Center, Hospital of the University of Pennsylvania Health System, White Building, 3400 Spruce Street, Philadelphia, PA 19104, USA.
El Abd
Omar H
OH
Bhargava
Amit
A
DePalma
Michael J
MJ
Chin
Kingsley R
KR
D000328:Adult; D001416:Back Pain / Q000150:complications / Q000534:rehabilitation; D017217:Blood Patch, Epidural / Q000295:instrumentation / Q000379:methods*; D002574:Cervical Vertebrae; D005260:Female; D006261:Headache / Q000150:complications / Q000628:therapy*; D006801:Humans; D019547:Neck Pain / Q000150:complications / Q000534:rehabilitation; D020069:Shoulder Pain / Q000150:complications / Q000534:rehabilitation; D016896:Treatment Outcome