Huge sebaceous cyst

[clubdeac]

So I was asked to do a left L5 TFESI on a patient from the neurosurgeon. Upon reviewing the MRI, I see there is a monstrous sebaceous cyst in the dermis directly in my needle path. I'm thinking of doing an interlaminar to avoid it. You guys think this a big deal or no?

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[lobelsteve]

So I was asked to do a left L5 TFESI on a patient from the neurosurgeon. Upon reviewing the MRI, I see there is a monstrous sebaceous cyst in the dermis directly in my needle path. I'm thinking of doing an interlaminar to avoid it. You guys think this a big deal or no?

Going through a cyst is a bad idea.

 

[Gauss]

drain the cyst and bill like derm!

 

[SSdoc33]

definitely avoid the cyst. if it looks red or tender, abort the procedure and have that sucker drained/excised

 

[hyperalgesia]

I excised one of these as a surg intern and it was incredibly satisfying. Can't believe it's been 15 years and I still remember that...

Would do paramedian IL and call it a day.

 

[Ducttape]

I used to excise cysts all the time in ER.

If you do, use lido diffusely but sparingly. Try to keep it all subcutaneous. Nothing is worse than putting in too much local and having it burst... in your face...

 

[SommeRiver]

Pop that thing "by accident."