ArticleAJNR. American journal of neuroradiology2025
Patterns of Epidural Patch Distribution: The Influence of Spinal Level, Injection Technique, and Patch Volume/Composition on Craniocaudal and Ventral Epidural Dispersion.
Article in AJNR. American journal of neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Manual Therapy-Associated Dural Tear Causing Intracranial Hypotension Treated with an Epidural Blood Patch: A Case Report.Journal of clinical medicine · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeEpidural patching with autologous blood and/or fibrin sealant is a common treatment for spinal CSF leaks, yet the factors influencing patch distribution remain poorly understood. This study aimed to analyze the craniocaudal (CC) and ventral epidural (VE) extent of epidural patch material and investigate the impact of variables such as patch volume (PV), composition, spinal level of injection, and patient habitus on distribution patterns. MATERIALS AND
methodsThis retrospective, cross-sectional cohort study included patients who underwent CT-guided epidural patching from January to September 2024. Inclusion criteria were age ≥18 years, dorsal interlaminar (DI) or transforaminal (TFO) epidural patching by using blood, fibrin, or both, and immediate postpatch imaging capturing the entire patch extent. Patch distribution was assessed for CC and VE spread. Statistical analyses included linear and logistic regression models, with multivariate analyses adjusting for confounders.
resultsOf 152 patients patched during the study period, 33 met inclusion criteria (mean age 45.4 years; 84.1% women) with 44 spinal levels patched: cervical (6.8%), thoracic (68.2%), and lumbar (25%). Mean PV per needle was 7.2 mL, with a mean CC spread of 4.6 spinal levels. There was a positive relationship between PV and CC spread across all spinal levels (β = 0.29,
conclusionsThe distribution of epidural patch material is influenced by spinal level, PV, composition, and injection approach. Cervical patches provide the greatest spread efficiency relative to volume, while DI approaches enhance CC spread but reduce ventral dispersion.
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