Simple intraoperative technique for hemostasis of cervical venous bleeding.
OBJECTIVE
To present a simple, fast, and efficient technique to control bleeding from the epidural venous plexus during anterior cervical discectomy.


METHODS
When encountering persistent bleeding from the venous epidural plexus during anterior cervical discectomy that cannot be controlled by bipolar coagulation, one can take approximately 5 to 10 ml of saline and connect the syringe to a curved blunt cannula with an atraumatic tip. Subsequently, the atraumatic tip of the syringe is placed between the dura and the bony edge and then the saline is powerfully injected into the epidural space. This will stop the bleeding.


RESULTS
This technique has been applied in 118 cases of anterior cervical discectomies and has proven to be very effective. We did not have to apply another hemostatic technique to control bleeding from the epidural plexus in any of our cases.


CONCLUSIONS
We present a simple and effective hemostasis technique to control bleeding from the cervical epidural venous plexus by injecting saline into the epidural space. We speculate that the mechanism by which the bleeding is controlled consists of filling the epidural space with saline; this elevated "pressure" controls the bleeding in a very effective way. Moreover, some venous contraction may occur because of the saline injection.
Menovsky
Tomas
T
Department of Neurosurgery, University Hospital Antwerp, Antwerp, Belgium. tomas.menovsky@uza.be
De Ridder
Dirk
D
D002574:Cervical Vertebrae / Q000098:blood supply* / Q000187:drug effects / Q000601:surgery*; D017586:Diskectomy / Q000009:adverse effects*; D006489:Hemostatic Techniques; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D019106:Postoperative Hemorrhage / Q000628:therapy*; D012965:Sodium Chloride / Q000008:administration & dosage*; D016896:Treatment Outcome; D014680:Veins / Q000187:drug effects*
D012965:Sodium Chloride