Editor-in-Chief: Alaa Abd-Elsayed, MD, PhD
Background: Neuraxial procedures have the risk of causing dural compromise that leads to postdural puncture headaches (PDPH). PDPH is normally treated conservatively with oral agents, such as nonsteroidal anti-inflammatory drugs and caffeine, or invasively with epidural blood patches (EBP). There is a paucity of evidence for the use of lumbar EBP in cases where the suspected chronic dural defect is at the cervical level.
Case Report: A 47-year-old patient who underwent C4-C6 posterior extension of fusion as well as right-sided C5-C6 foraminotomy subsequently developed chronic PDPH symptoms that were refractory to conservative interventions. A lumbar EBP was performed for suspected cervical dura compromise, with near-immediate resolution of symptoms that lasted for multiple months.
Conclusion: Lumbar EBP should be considered in patients with suspected PDPH from cervical dural compromise, especially in the context of a prolonged clinical course or failure of conservative means.
Key words: Case report, cervical dura compromise, lumbar epidural patch, postdural puncture headache