InjectionДЄfter an epidural location is confirmed, the patient's blood is withdrawn (discarding the first 10-20 mL). Once the epidural space is entered, extravascular and extrathecal location is confirmed with the injection of a small amount of contrast.Дepending on how well the contrast spreads craniocaudally and/or left to right repeated injections on the contralateral side or at the level above/below may be of benefit 20. This may also limit the frequency of intravenous injection 20. Ideally, given that radiculomedullary arteries are located anterior to the nerve in the upper third of the foramen, the needle should pass through the inferior third. Needle) is advanced along an anteromedial trajectory through the transverse foramen and into the ventral epidural space. With CT guidance a needle (e.g.12-15 cm 22G or 25G spinal or Quincke point In cases where non-targeted or interlaminar blood-patches are unsuccessful, or where a ventral defect is demonstrated, then a transforaminal approach can be used typically with CT guidance 20. Interlaminar access to the spinal epidural space can be done under fluoroscopy or CT, and is essentially identical to one described in the article on lumbar interlaminar epidural injection. antecubital) is performed, the cannula connected to an extension tube (kept sterile) and flushed. CannulationДЄt the beginning of the procedure, sterile venous cannulation (e.g. preprocedural imaging has demonstrated the site of CSF leak - see craniospinal hypotension) or non-targeted 2. allergy to any of the planned medicationsД®pidural blood patches can be targeted (i.e.craniospinal hypotension including post-lumbar puncture headache.

Radiculopathy after blood patch