Manchikanti L, Bakhit C E
Pain Management Center of Paducah, Kentucky, USA.
Reg Anesth. 1997 Nov-Dec;22(6):579-81.
Epidural adhesiolysis, described by Racz et al. (1) utilizing a double-contrast injection technique, provides an epidurogram that clearly delineates the area of adhesions and furnishes a means to perform lesion-specific lysis of adhesions utilizing a flexible wire-embedded catheter.
A caudal/lumbar epidurogram followed by lysis of adhesions was attempted in a 68-year-old male suffering with severe, low back pain with radiation into both lower extremities, using R-K needle and the Racz catheter (Medic Epimed, Gloversville, NY) under fluoroscopic visualization.
After the cannulation and during the attempts to manipulate, the Racz catheter was sheared and was retained in the epidural space. After unsuccessfully attempting to remove it endoscopically, it was successfully removed using arthroscopy forceps.
This case report illustrates a difficult situation with a sheared and retained epidural catheter which could not be removed utilizing the standard techniques but was successfully removed without any residual problems using arthroscopy forceps.
拉茨等人(1)采用双对比注射技术描述的硬膜外粘连松解术,可提供清晰描绘粘连区域的硬膜外造影,并提供一种利用柔性埋线导管对粘连进行病灶特异性松解的方法。
在一名68岁患有严重腰痛并向下肢放射的男性患者中,在荧光透视下使用R-K针和拉茨导管(Medic Epimed,纽约州格洛弗斯维尔)尝试进行骶管/腰椎硬膜外造影,随后进行粘连松解。
插管后及操作过程中,拉茨导管被剪断并留在硬膜外间隙。在内镜下尝试取出失败后,使用关节镜钳成功取出。
本病例报告说明了硬膜外导管剪断并残留的困难情况,这种情况无法使用标准技术取出,但使用关节镜钳成功取出,且无任何残留问题。