Lumbar Epidural Blood Patch via a Caudal Catheter After Surgical Dural Tear and Failed Repair: A Case Report.
We report a patient who developed a positional headache and pseudomeningocele after multiple lumbar surgeries for low back and radicular pain. An epidural blood patch via a lumbar approach was not feasible as a result of distorted lumbar anatomy after multiple back surgeries. An epidural blood patch was performed via catheter-threaded cephalad from a caudal approach. The patient had immediate relief after the procedure and at 1 year was still symptom-free. This combination technique may be considered as an alternative approach when a percutaneous lumbar epidural blood patch is disadvantageous.
From the Department of Anesthesiology, Geisinger Medical Center, Danville, Pennsylvania.
Michael
M
Dorbad
John
J
Han
Shaik
S
Ahmed
Brian
B
Monroe
Michael
M
Entrup
D000293:Adolescent; D017217:Blood Patch, Epidural / Q000379:methods*; D004388:Dura Mater / Q000293:injuries*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000601:surgery*; D008159:Lumbar Vertebrae; D019637:Orthopedic Procedures; D051299:Post-Dural Puncture Headache / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D012008:Recurrence; D013129:Spinal Puncture / Q000009:adverse effects*; D016896:Treatment Outcome