Epidural blood patch as treatment for CSF leak during spinal cord stimulator implantation

Kia, Farid; Zhou, Linqiu; Berk, Jason D.

doi:10.1016/j.jpain.2011.02.284

Cited by 2 publications

(2 citation statements)

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“…A patient's predisposition for infectious complications following EBP must be weighed against the technical difficulty of lead insertion. Even though the routine use of prophylactic EBP for PDPH prevention has not been recommended and remains contentious, more recent and specific data to percutaneous SCS lead insertion suggests that prophylactic EBP performed intraoperatively can be very effective . One may also consider the feasibility of moving to a different insertion site far from the location of a future possible blood patch (as in patient 5) is also be an important consideration.…”

Section: Discussionmentioning

confidence: 99%

The Incidence and Management of Postdural Puncture Headache in Patients Undergoing Percutaneous Lead Placement for Spinal Cord Stimulation

Simopoulos

Sharma

Aner

et al. 2016

Neuromodulation: Technology at the Neural Interface

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Section: Discussionmentioning

confidence: 99%

The Incidence and Management of Postdural Puncture Headache in Patients Undergoing Percutaneous Lead Placement for Spinal Cord Stimulation

Simopoulos

Sharma

Aner

et al. 2016

Neuromodulation: Technology at the Neural Interface

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“…The NACC discusses intraoperative blood patch and assigns evidence level III and recommendation C -neither recommendable nor inadvisable to this approach (15). Studies have shown that a prophylactic (intraoperative) epidural blood patch (EBP) can be effective in treating PDPH (30)(31)(32)(33). Other studies have shown that it may not be efficacious in prophylaxis of PDPH (34).…”

Section: Epidural Blood Patch and Other Approaches During Scs Proceduresmentioning

confidence: 99%

Dural Puncture During Spinal Cord Stimulator Lead Insertion: Analysis of Practice Patterns

et al. 2022

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Background: Spinal cord stimulation (SCS) is an important modality for intractable pain not amenable to less conservative measures. During percutaneous SCS lead insertion, a critical step is safe access to the epidural space, which can be complicated by a dural puncture. Objectives: In this review, we present and analyze the practices patterns in the event of a dural puncture during a SCS trial or implantation. Methods: We conducted a survey of the practice patterns regarding spinal cord stimulation therapy. The survey was administered to members of the Spine Intervention Society and American Society of Regional Anesthesia specifically inquiring decision making in case of inadvertent dural puncture during spinal cord stimulator lead insertion. Results: A maximum of 193 responded to a question regarding dural punctures while performing a SCS trial and 180 responded to a question regarding dural punctures while performing a SCS implantation. If performing a SCS trial and a dural puncture occurs, a majority of physicians chose to continue the procedure at a different level (56.99%), followed by abandoning the procedure (27.98%), continuing at the same level (10.36%), or choosing another option (4.66%). Similarly, if performing a permanent implantation and a dural puncture occurs, most physicians chose to continue the procedure at a different level (61.67%), followed by abandoning the procedure (21.67%), continuing at the same level (10.56%), or choosing another option (6.11%). Conclusions: Whereas the goals of the procedure would support abandoning the trial but continuing with the permanent in case of inadvertent dural puncture, we found that decision choices were minimally influenced by whether the dural puncture occurred during the trial or the permanent implant. The majority chose to continue with the procedure at a different level while close to a quarter chose to abandon the procedure. This article sets a time stamp in practice patterns from March 20, 2020 to June 26, 2020. These results are based on contemporary SCS practices as demonstrated by this cohort, rendering the options of abandoning or continuing after dural puncture as reasonable methods. Though more data is needed to provide a consensus, providers can now see how others manage dural punctures during SCS procedures.

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Epidural blood patch as treatment for CSF leak during spinal cord stimulator implantation

Cited by 2 publications

References 0 publications

The Incidence and Management of Postdural Puncture Headache in Patients Undergoing Percutaneous Lead Placement for Spinal Cord Stimulation

The Incidence and Management of Postdural Puncture Headache in Patients Undergoing Percutaneous Lead Placement for Spinal Cord Stimulation

Dural Puncture During Spinal Cord Stimulator Lead Insertion: Analysis of Practice Patterns

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