• A&A practice · Sep 2024

    Case Reports

    A Case of a Cerebrospinal Fluid Leak Secondary to Chiropractic Manipulation of the Thoracic Spine.

    • Jordan J Bozer, Katelynn M Helfrich, Gabriella R Seidler, Alexandrea L Garrett, and Nasir Hussain.
    • From the Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio.
    • A A Pract. 2024 Sep 1; 18 (9): e01844e01844.

    AbstractChiropractic spinal manipulation therapy (CSMT) of the cervical spine has been reported to cause mechanical dural injuries that result in cerebrospinal fluid (CSF) leaks. We present a case of symptomatic intracranial hypotension after isolated thoracic CSMT. Initial imaging was unable to definitively localize the CSF leak, but dynamic imaging was able to better identify the defect. Multiple epidural blood patches were attempted, including image-guided approaches and with fibrin sealant, but surgical repair was ultimately required. Our case illustrates the risk of dural tear in the setting of recent CSMT and the challenges of managing such an injury.Copyright © 2024 International Anesthesia Research Society.

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