Intrathecal Therapy in a Patient With Solid Arthrodesis of the Interlaminar Spaces: A Case Report.
David Jung, Maha Malik, Tariq M Malik
✦ AI-curated · Sources linked
Case in brief
A 48-year-old woman with a history of L2-S1 arthrodesis required intrathecal catheter placement for refractory chronic pain. After conventional fluoroscopic access failed and open surgery was aborted, a fluoroscopy-guided percutaneous transosseous approach was utilized. The procedure resulted in a large dural defect and cerebrospinal fluid leak, which were effectively managed with sequential caudal epidural blood patches.
What made this case unusual
The use of a fluoroscopy-guided percutaneous transosseous approach for intrathecal catheter placement in a patient with solid arthrodesis is noteworthy, as it demonstrates an alternative technique in complex anatomical situations.
Diagnostic / clinical pearl
Clinicians should consider transosseous access for intrathecal catheter placement in patients with challenging spinal anatomy due to prior fusions.
Why it matters
This case underscores the importance of innovative techniques and targeted management strategies, such as blood patching, in addressing complications arising from complex spinal surgeries.