Epidural blood patches are considered definitive treatment for postdural puncture headache in adult patients. However, they are infrequently used in children or in patients with altered spine anatomy. In patients who have undergone recent spine surgery, the lumbar epidural space can be approached safely via the caudal canal. Our case demonstrates a novel technique to perform an epidural blood patch from a caudal approach using a commonly available central line kit for a 15-year-old patient with severe spinal headache due to cerebrospinal fluid leak following a hemilaminectomy.
Keywords: acute pain; epidural blood patch; equipment; postdural puncture headache; regional anesthesia.
Lay abstract An epidural blood patch is an injection of the patient’s own blood into their back in the epidural space, which is the definitive treatment for headaches as a result of spinal fluid leakage. However, they are infrequently used and difficult to perform in children or in patients who have had prior back surgeries. In patients who have undergone recent spine surgery, their back-epidural space can be approached safely through caudal canal near the tailbone. Our case demonstrates a novel technique to perform an epidural blood patch from a caudal approach using a commonly available central line kit in a 15-year-old patient with severe spinal headache due to cerebrospinal fluid leak after a back surgery.