Su Hui, Lan Xiaoyang, Cao Ya, Zhang Mingjie, Chen Xiaoyan, Lan Chen
Department of Neurology, Chinese PLA General Hospital First Medical Center, Beijing, China.
Department of Anesthesiology, Chinese PLA General Hospital First Medical Center, Beijing, China.
Technol Health Care. 2025;33(1):567-575. doi: 10.3233/THC-241366.
Epidural blood patch (EBP) is a minimally invasive and effective treatment for spontaneous intracranial hypotension (SIH). But, cervical epidural blood patch for SIH has little attention.
In this study, The clinical data was recorded and the treatment efficacy and safety of cervical EBP in SIH were evaluated.
: Fifty-nine cases of intractable SIH were examined by computed tomography (CT) guided cervical EBP at the Chinese PLA General Hospital from August 2014 to March 2024.
The mean age of the fifty-nine patients at symptom onset was 40.8 ± 9.5 years. 54/59 (91.5%) patients experienced orthostatic headache. Preoperative spine T2 scans with extensive fluid collection at the upper cervical region in 43/46 (93.5%). 45/59 (76.3%) patients had symptomatic relief with initial cervical EBP, and 14/59 (23.7%) patients received further cervical EBPs. In the first one to three days following the EBP procedure, 11 (18.6%) patients reported pain at the puncture site and 15 (25.4%) experienced neck pain. No other complications were observed during or after the procedure. At the latest follow-up, all patients showed good recovery. The mean follow-up was 28.9 ± 22.7 months.
CT-guided cervical EBP is a effective and safe treatment for patients with intractable SIH, especially in patients who had extensive fluid collection at the upper cervical region.
硬膜外血贴（EBP）是治疗自发性颅内低压（SIH）的一种微创且有效的方法。但是，用于SIH的颈椎硬膜外血贴很少受到关注。
本研究记录临床数据，评估颈椎EBP治疗SIH的疗效和安全性。
2014年8月至2024年3月，在中国人民解放军总医院对59例难治性SIH患者进行了计算机断层扫描（CT）引导下的颈椎EBP检查。
59例患者症状发作时的平均年龄为40.8±9.5岁。54/59（91.5%）的患者出现体位性头痛。43/46（93.5%）的患者术前脊柱T2扫描显示上颈椎区域有广泛的液体聚集。45/59（76.3%）的患者首次颈椎EBP后症状缓解，14/59（23.7%）的患者接受了进一步的颈椎EBP。在EBP操作后的头1至3天，11（18.6%）例患者报告穿刺部位疼痛，15（25.4%）例患者出现颈部疼痛。操作期间或之后未观察到其他并发症。在最近一次随访时，所有患者均恢复良好。平均随访时间为28.9±22.7个月。
CT引导下的颈椎EBP是治疗难治性SIH患者的一种有效且安全的方法，尤其是对上颈椎区域有广泛液体聚集的患者。
