Inadvertent Dural Puncture during Caudal Approach by the Introducer Needle for Epidural Adhesiolysis Caused by Anatomical Variation.
10.3344/kjp.2013.26.2.203
- Author:
Si Gon KIM
1
;
Jong Yeun YANG
;
Do Wan KIM
;
Yeon Ju LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, Ajou University College of Medicine, Suwon, Korea. yjyhy@hanmail.net
- Publication Type:Brief Communication
- Keywords:
anatomical variation;
caudal block;
dural puncture
- MeSH:
Humans;
Ligaments;
Lumbosacral Region;
Magnetic Resonance Imaging;
Needles;
Punctures
- From:The Korean Journal of Pain
2013;26(2):203-206
- CountryRepublic of Korea
- Language:English
-
Abstract:
There have been reports of abnormalities in the lumbosacral region involving a lower-than-normal termination of the dural sac, which is caused by disease or anatomical variation. Inadvertent dural puncture or other unexpected complications can occur during caudal epidural block or adhesiolysis in patients with these variations, but only a small number of case reports have described this issue. We report a case of dural puncture by the introducer needle before attempting caudal epidural adhesiolysis, which occurred even though the needle was not advanced upward after penetrating the sacrococcygeal ligament. Dural puncture was caused by a morphological abnormality in the lumbosacral region, with no pathological condition; the dural sac terminal was located more distally than normal. However, dural puncture could have been prevented if we had checked for such an abnormality in the magnetic resonance imaging (MRI) taken before the procedure.
