Open AccessTransforaminal Epidural Blood Patch
Author(s) -
Lawrence Weil,
Richard I Gracer,
Neal H. Frauwirth
Publication year - 2007
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2007/10/579
Subject(s) - medicine , epidural blood patch , laminectomy , surgery , anesthesia , lumbar , back pain , complication , conservative management , spinal cord , alternative medicine , pathology , psychiatry
Spinal headache is an occasional, but painful complication of epidural injectionprocedures due to dural puncture that allows leakage of CSF from the thecal sac,thereby reducing intracranial pressure. In the event of failure of conservative management, (e.g. abdominal binder, fluids, acetaminophen), an epidural blood patchis often used.This case report describes a patient with spinal headache after a transforaminalselective epidural injection in a post laminectomy patient that was treated with atransforaminal epidural blood patch after the failure of conservative management.The patient underwent left transforaminal epidural injections at L5 and S1 formanagement of chronic low back pain secondary to post laminectomy syndrome.Three days later, the patient presented with a severe post lumbar puncture headache and failed to respond to conservative management. Interlaminar epidural approach for blood patch was not feasible secondary to prior laminectomy. Transforaminal epidural blood patch was performed utilizing 2 mL of autologous blood ateach of the two sites. The patient recovered well without headache.In cases, with inability to perform interlaminar blood patch, a transforaminal approach may be considered.Key words: blood patch, epidural, spinal headache, transforaminal