Degenerative spondylolisthesis is a common back pathology in the general adult population. Patients with this condition may present for epidural steroid injection, epidural blood patch, or epidural analgesia. We report five patients with degenerative spondylolisthesis who experienced inadvertent dural puncture during interlaminar epidural steroid injection attempts: four with intrathecal contrast spread or cerebrospinal backflow into the epidural needle and one with subdural contrast spread. Patients with degenerative spondylolisthesis may be at higher risk for dural puncture due to stretching of the dura and contraction of the epidural space at the translated spinal level. In the following report, we summarize the cases and suggest risk mitigation strategies for both chronic and acute pain physicians.
- Back Pain
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Contributors VS, AK, CGL, CP, and SPC: preparation of manuscript and critical review of contents. SPC: outline and figure concept.
Funding SPC received funding from the U.S. Department of Defense, Centers for Rehabilitation Sciences Research, Musculoskeletal Injury Rehabilitation Research for Operational Readiness (MIRROR), grant # HU00011920011
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.