Epidural blood patch: Comparison of fluoroscopic guided technique versus non-fluoroscopic (blind) technique

Epidural blood patch (EBP) is an accepted modality for the treatment of post dural puncture headache (PDPH). Most EBP procedures are done without the use of fluoroscopy, although fluoroscopic guided epidural needle positioning has been demonstrated to be more accurate than conventional (blind) technique. In our study: we compared the two approaches in 26 patients with PDPH. There were three cases in the conventional (blind) group who had inadequate pain relief, yet none in the fluoroscopic guided group. We conclude that EBP performed utilizing fluoroscopic guidance will result in a better outcome. Although we do not recommend fluoroscopic use for all EBP, we reserve this technique for patients with altered anatomic landmarks (patient with previous lumber spine surgery) or those who did not have adequate relief of symptoms with conventional (blind) technique.