Treatment of Refractory Postdural Puncture Headache after Intrathecal Drug Delivery System Implantation with Epidural Blood Patch Procedures: A 20-Year Experience

Markus A. Bendel, Susan M. Moeschler, Wenchun Qu, Eugerie Hanley, Stephanie A. Neuman, Jason S. Eldrige, Bryan C. Hoelzer

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

A recent publication reported the incidence of postdural puncture headache (PDPH) in conjunction with intrathecal drug delivery system (IDDS) implantation to be nearly 23 percent. Many patients responded to conservative measures but a percentage needed invasive treatment with an epidural blood patch (EBP). There is limited data to describe the technical details, success rates, and complications associated with EBP in this population. This study aims to provide a retrospective report of EBP for patients suffering from PDPH related to IDDS implantation. A chart review established a cohort of patients that required EBP in relation to a PDPH after IDDS implantation. This cohort was evaluated for demographic data as well as details of the EBP including technical procedural data, success rates, and complications. All patients received a trial of conservative therapy. Standard sterile technique and skin preparation were utilized with no infectious complications. The EBP was placed below the level of the IDDS catheter in 94% of procedures. Fluoroscopy was utilized in each case. The mean EBP volume was 18.6 cc and median time of EBP was day 7 after implant. There were no complications associated with EBP. EBP appears to be an effective intervention in this subset of PDPH patients.

Original languageEnglish (US)
Article number2134959
JournalPain Research and Treatment
Volume2016
DOIs
StatePublished - Jan 1 2016

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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