ESI for Dural Ectasia?

[knoxdoc]

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I have a 27 y/o F patient with NF1 and dural ectasia on MRI. She has R L5 radicular pain and numbness, but no objective findings. MR showed dural ectasia and scalloping c/w her NF1, but no disc abnormalities and no nerve sheath tumors. Has anyone has success with ESIs for these folks? I'm a little concerned about the increased risk of wet tap from even a TF approach. I'll have to stare at the films a little more before I proceed.

 

[PMR 4 MSK]

Mri was with contrast?

 

[knoxdoc]

Mri was with contrast?

No, she had it before she came my way. Good thought to be on the safe side.

 

[brori]

S1 transforaminal or caudal cath might be approaches to consider.

 

[Aether2000]

Consider using a blunt needle (rounded blunt) approach.