Percutaneous epidural adhesiolysis (PEA) is a minimal invasive procedure to relieve sciatalgia caused by post lumbar surgery syndrome (PLSS). Fluoroscopic-guided contrast-epidurography is essential to ensure a safe procedure. We present a case of a 28-year-old male patient who underwent a PEA which was complicated by a dural puncture. We highlight the dangers of such complications and discuss associated risk factors.
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http://dx.doi.org/10.2147/IMCRJ.S370185 | DOI Listing |
Int Med Case Rep J
November 2022
Department of Anesthesiology and Pain Management, Antwerp University Hospital (UZA), Edegem, Belgium.
Percutaneous epidural adhesiolysis (PEA) is a minimal invasive procedure to relieve sciatalgia caused by post lumbar surgery syndrome (PLSS). Fluoroscopic-guided contrast-epidurography is essential to ensure a safe procedure. We present a case of a 28-year-old male patient who underwent a PEA which was complicated by a dural puncture.
View Article and Find Full Text PDFAnesth Pain Med
June 2016
Department of Family Medicine and Community Health, University of Wisconsin, School of Medicine and Public Health, Madison, USA.
Background: Anecdotal evidence suggests that a vertical small-needle injection method enters the caudal epidural space with comparable efficacy to cephalad-directed methods, with less intravascular injection.
Objectives: Assess the success rate of vertical caudal epidural injection using epidurography and the frequency of intravascular injection using a vertical small-needle approach.
Patients And Methods: Participants had chronic generalized non-surgical low back pain and either gluteal and/or leg pain and were enrolled in a simultaneous clinical trial assessing the analgesic effect of 5% dextrose epidural injection.
Background: Thoracic epidural anesthesia (TEA) is frequently used to maintain intraoperative analgesia. After injecting the initial bolus dose of epidural local anesthetics (LA), intermittent injection of LA through an epidural catheter is required to maintain the intraoperative analgesia. For intermittent epidural administration, usually 2 - 5 mL of LA has been used.
View Article and Find Full Text PDFPain Pract
June 2015
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Objective: The positive effects of percutaneous epidural neuroplasty (PEN) likely result from elimination of fibrous tissue. However, a direct link between epidural adhesions and pain symptoms is debatable. We tested the hypothesis that epidurographic improvements correspond to improved patient outcome.
View Article and Find Full Text PDFInt J Spine Surg
February 2015
Department of Neurosurgery, University of Cincinnati Academic Health Center, Cincinnati, OH ; Mayfield Clinic, Cincinnati, OH.
Background: Given the risk of paralysis associated with cervical transforaminal injection, is it time to reconsider transforaminal injections of the lumbar spine? Arguments for discontinuing lumbar injections have been discussed in the anesthesia literature, raising concern about the risks of epidural steroid injections (ESIs).
Methods: In a 47-year-old man, paraplegia of the lower extremities developed, specifically conus medullaris syndrome, after he underwent an ESI for recurrent pain. Correct needle placement was verified with epidurography.
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