We describe a case of spinal cord injury caused by direct trauma from a local anaesthetic infiltration needle. During local anaesthetic infiltration before placement of an epidural catheter, the patient suddenly rolled over onto her back, causing the infiltrating needle to advance all the way to its hub. She immediately showed signs of spinal cord injury, confirmed by MRI scan. However, her neu...

BACKGROUND Factors contributing to subarachnoid catheter passage after epidural placement are not well understood. This study explored mechanisms that might explain its occurrence. METHODS Human cadaveric dura was mounted on a model and pressurized to physiologic levels. In a standardized fashion, a 20-gauge Portex three-port, closed end (nonflexible) tip catheter was passed through an epidur...

Neuromodulation with spinal cord stimulation is a proven, cost effective treatment for the management of chronic radicular low back pain from failed low back surgery syndrome and other neuropathic pain conditions. The traditionally instructed method for percutaneous spinal cord stimulator lead placement promotes the use of a "loss of resistance" technique under anteroposterior fluoroscopic guid...

The actual incidence of neurological dysfunction resulting from haemorrhagic complications associated with neuraxial block is unknown. Although the incidence cited in the literature is estimated to be <1 in 150,000 epidural and <1 in 220,000 spinal anaesthetics, recent surveys suggest that the frequency is increasing and may be as high as 1 in 3000 in some patient populations. Overall, the risk...

Postdural puncture back pain has a reported incidence ranging from 2% to 29% following the administration of a spinal anesthetic. The purpose of this investigation was to compare the back pain and patient satisfaction scores after the administration of a spinal anesthetic with or without the use of an 18-gauge introducer needle. Eighty-four men and women were randomly assigned to either control...

Thoracotomies are among the most painful of surgical incisions. Postoperatively, the movement of the chest with each breath increases the pain, and patients often “splint” to the point of hypercapnea or hypoxia. Substantial analgesia is required to avoid postoperative respiratory complications, but heavy opioid use blunts the respiratory drive and may itself be associated with postoperative com...

BACKGROUND Percutaneous diagnostic and therapeutic procedures are commonly used in the treatment of spinal pain. The success of these procedures depends on the accuracy of needle placement, which is influenced by needle size and shape. OBJECTIVES The purpose of this study is to examine and quantify the deviation of commonly used spinal needles based on needle tip design and gauge, using a bal...

OBJECTIVE We conducted this study to develop a sonographically guided approach to the spinal nerve of the lumbar spine and to assess its feasibility and accuracy by means of computed tomography (CT). METHODS Fifty sonographically guided approaches at 5 levels (L1-S1) were performed on 5 embalmed cadavers, which were positioned prone. The spinal nerves of the lumbar spine were shown under sono...

how to cite this article: bani hashem a, heydarian f, gharavi m, khoshnod m. postdural puncture headache: incidence and risk factors in children followingintrathecal chemotherapy. iranian journal of child neurology 2012;6(1):19-22. objective to evaluate the incidence and risk factors of development of postdural puncture headache in children who had intrathecal chemotherapy injection. materials ...

conclusions in squatting position the number of spinal needle-bone contacts was lower compared to the traditional sitting position, nonetheless ease of needle insertion or space identification was the same in the both groups. results the total number of spinal needle bone contact was statistically lower in the squatting position compared to traditional sitting position group (222 versus 230 res...