Transforaminal Epidural Blood Patches for the Remedy of Postsurgical Dural Leaks: Two Case Stories.
PM R. 2017 Jan;9(1):83-87
Authors: Goodman B, Vallabhaneni S, Cubitt B, Mallempati S
Unintended dural punctures with leakage of cerebrospinal fluid (CSF) are acknowledged as a frequent complication of spinal surgical procedure. Though conservative or invasive choices could also be used to deal with postoperative CSF leaks, the present literature doesn’t outline both an algorithmic therapy strategy or a universally accepted normal of care. We imagine transforaminal epidural blood patch (EBP) can function a minimally invasive, cost-effective choice to deal with postsurgical CSF leaks that don’t resolve with conservative administration. We now have carried out an EBP through the transforaminal path to deal with postsurgical CSF leaks in each the cervical and lumbar backbone. The primary case describes a affected person who underwent an anterior cervical diskectomy and fusion with a complication of profuse CSF leakage. The applying of a cervical transforaminal EBP on the ranges of surgical restore was efficient in stopping the dural leak. The second case entails a affected person who skilled basic positional spinal complications after a lumbar hemilaminectomy and diskectomy. After utilization of lumbar transforaminal EBPs, his signs revolved. This text presents the potential use of an EBP through the transforaminal path to deal with postsurgical dural leaks in each the cervical and lumbar area.
LEVEL OF EVIDENCE: V.
PMID: 27317911 [PubMed – indexed for MEDLINE]