Cervical epidural blood patch--A literature review

Area of Science:

• Neurosurgery
• Pain Management

Background:

• Cervical epidural blood patches (EBP) are infrequently performed due to concerns about neurological complications.
• Cervical cerebrospinal fluid (CSF) leaks can cause debilitating positional headaches.

Purpose of the Study:

• To review the literature on the performance, safety, and efficacy of cervical EBPs for treating cervical CSF leaks.
• To provide an evidence-based assessment of cervical EBP indications, techniques, and outcomes.

Main Methods:

• A comprehensive literature search identified 15 studies involving 19 patients with cervical CSF leaks.
• Data on indications, leak levels, EBP procedures, blood volumes, and complications were collected and analyzed.

Main Results:

• All 19 patients experienced positional headaches due to cervical CSF leaks.
• 11 patients received a cervical EBP without prior lumbar EBP, and 8 patients had a cervical EBP after incomplete relief from a lumbar EBP.
• All patients reported complete, long-term pain relief following cervical EBP, with an average injection of 5-8 mL of blood. No major neurological complications were observed.

Conclusions:

• Cervical EBPs are a safe and effective treatment option for patients suffering from positional headaches caused by cervical CSF leaks.
• The procedure carries a low risk of serious adverse events, supporting its use in clinical practice.