Symptomatic Postlaminectomy Cerebrospinal Fluid Leak Treated With 4-Dimensional Ultrasound-guided Epidural Blood Patch
Journal of Neurosurgical Anesthesiology , 06/14/2012
Clendenen SR et al. – Real–time ultrasound (US) guidance allowed accurate positioning of the Tuohy needle and deposition of the epidural blood patch in the setting of a surgically removed ligamentum flavum.Methods
- Six patients, after lumbar spine surgery with instrumentation and primary closure was complicated by incidental dural tears, developed severe symptomatic headaches that failed conservative therapy.
- All patients underwent US–guided epidural blood patch.
- Precise needle advancement to the dura was observed with US guidance, and 4–dimensional US scanning was used to confirm the expansion of blood over the dura in real time.
- All patients had symptomatic relief of their headaches and successful treatment of dural leaks using US–guided blood patch.