Extradural and subarachnoid catheterization using the Seldinger technique

Area of Science:

• Neurosurgery
• Pain Management
• Medical Devices

Background:

• Traditional methods for introducing spinal devices risk damaging soft silicone catheters and leads.
• Modified Tuohy needles have limitations in extradural space localization and device compatibility.

Purpose of the Study:

• To evaluate the safety and efficacy of the Seldinger technique for introducing spinal catheters, extradural stimulation leads, and fibreoptic scopes.
• To compare the Seldinger technique with the standard Tuohy needle method for device insertion.

Main Methods:

• The Seldinger technique was utilized with a plastic introducer for device insertion.
• Procedures included spinal silicone catheter (n=14), extradural silicone stimulation lead (n=2), and fibreoptic endoscope (n=9) placements.
• A total of 25 procedures were performed in 18 patients.

Main Results:

• The Seldinger technique successfully facilitated the introduction of various devices without damaging them.
• Paraesthesiae occurred in awake patients, similar to the Tuohy needle technique, with no neural damage reported.
• The incidence of post-spinal headache was comparable between the Seldinger technique and the standard Tuohy needle method.

Conclusions:

• The Seldinger technique provides a viable alternative for introducing spinal and extradural devices, minimizing the risk of mechanical damage.
• It offers comparable safety and efficacy to traditional methods for managing chronic pain and spasticity.
• The technique is suitable for a range of devices, including catheters, stimulation leads, and endoscopes.