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Lumbar Tfesi and potential PDPH

jwalker12

Full Member
10+ Year Member
Aug 25, 2008
67
6
236
Hey everyone,
I did a L5-S1 and S1 TFESI using a 22g spinal needle on a patient recently. I was never past 6” on the pedicle in AP and contrast appeared epidural. Patient went home later in the day had a mild headache. Subsequently she did fine all day then 36 hours after the procedure developed a headache, bilateral occipital region to crown of the head. Doesn’t endorse postural improvement but I am thinking what if it is a PDPH. How could it have happened if I didn’t go too far into the foremen? It’s just not making sense to me. Thanks for any advice or tips always appreciated.
 
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