Dural leakage due to ipsilateral needle placement for spinal level localization in unilateral decompression surgery: A case report

Lukas Andereggen; Markus M Luedi

doi:10.25259/SNI_245_2021

Dural leakage due to ipsilateral needle placement for spinal level localization in unilateral decompression surgery: A case report

Surg Neurol Int. 2021 May 3:12:205. doi: 10.25259/SNI_245_2021. eCollection 2021.

Authors

Lukas Andereggen^{1

2}, Markus M Luedi³

Affiliations

¹ Department of Neurosurgery, Kantonsspital Aarau, Tellstrasse, Aarau.
² Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern.
³ Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrassse, Switzerland.

Abstract

Background: A spinal dural defect caused by needle placement for spinal level localization is an uncommon complication of cerebrospinal fluid leak with the potential for the development of intracranial hypertension.

Case description: Our 48-year-old patient underwent unilateral fenestration and sequestrectomy for intractable L5 radiculopathy due to disc herniation at the level L4-5 on the right side. The spinal level was identified with fluoroscopy after placement of a 24-gauge Sprotte spinal needle on the right side. Intraoperatively, a sub-millimeter spinal dural defect was visualized on the ipsilateral side.

Conclusion: Caution is needed when needle placement is used to localize the spinal level for unilateral surgery.

Keywords: Dural puncture; Intracranial hypotension; Lumbar spinal surgery; Postdural puncture headache; Sealing.

Publication types

Case Reports