Direct Visualization of the Dural Puncture Site During Lumbar

A&A practice · Feb 2021

Case Reports

Direct Visualization of the Dural Puncture Site During Lumbar Spine Surgery Performed Under Spinal Anesthesia: A Case Report.

Spinal anesthesia (SA) has been utilized for lumbar surgical procedures; however, postdural puncture headache (PDPH) and subdural hemorrhage (SDH) are potential consequences. We present the case of a 76-year-old with progressive neurogenic claudication secondary to lumbar spinal stenosis who received SA for a 2-level lumbar posterior decompression. ⋯ Our intraoperative image demonstrates the submillimeter dural defect that can potentially engender complications as significant as PDPH and/or SDH. We recommend searching for, and preemptively sealing, the dural puncture site when SA is used for lumbar spine surgery.

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- Melanie M Stipp, Pranav Nanda, Jean-Valery Coumans, and Robert A Peterfreund.
- From the Department of Anesthesia, Critical Care and Pain Medicine and.
- A A Pract. 2021 Feb 11; 15 (2): e01397e01397.
AbstractSpinal anesthesia (SA) has been utilized for lumbar surgical procedures; however, postdural puncture headache (PDPH) and subdural hemorrhage (SDH) are potential consequences. We present the case of a 76-year-old with progressive neurogenic claudication secondary to lumbar spinal stenosis who received SA for a 2-level lumbar posterior decompression. After decompression, the site of dural puncture from a 24-gauge Sprotte spinal needle was identified. Our intraoperative image demonstrates the submillimeter dural defect that can potentially engender complications as significant as PDPH and/or SDH. We recommend searching for, and preemptively sealing, the dural puncture site when SA is used for lumbar spine surgery.Copyright © 2021 International Anesthesia Research Society.

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Direct Visualization of the Dural Puncture Site During Lumbar Spine Surgery Performed Under Spinal Anesthesia: A Case Report.

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