Cervical Epidural Blood Patch
I had an interesting case present itself the other day. A patient had a steroid injection in the cervical area for arm pain and had PDPH symptoms within the day, went to the ED and we were consulted for an EBP. Given the location, I wasn’t comfortable doing the procedure at that level, and I had doubts doing it at lumbar region would reach high enough to treat it. I referred them to the doc that did the injection to do the patch and recommended conservative management in the meantime.
What would you have done? Anyone done a blood patch in the cervical area? How was it, what volume blood did you use and did the patient have any issues like the crampy/spasm-like pain that can sometimes happen after an EBP?
Edit: Thanks for the CME everyone, always glad to see perspectives from colleagues. At my practice we try to help when we can, but it’s a community hospital so we avoid doing things with minimal-to-no evidence in the literature.