Evidence map›Paper›PMID 40131573›Full record

ReviewCurrent pain and headache reports2025

Prophylactic Fibrin Glue Application for Immediate Management of Dural Puncture during Spinal Cord Stimulation Lead Placement: a Simple and Effective Technique.

Roberto Gazzeri, Marcelo Galarza, Felice Occhigrossi, Omar Viswanath, Giustino Varrassi, Matteo Luigi Giuseppe Leoni

Abstract readReview
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In one paragraph

Review in Current pain and headache reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Roberto GazzeriInterventional and Surgical Pain Management Unit, San Giovanni-Addolorata Hospital, Rome, Italy. robertogazzeri@gmail.com.
Marcelo GalarzaRegional Service of Neurosurgery, "Virgen de la Arrixaca" University Hospital, Murcia, Spain.
Felice OcchigrossiInterventional and Surgical Pain Management Unit, San Giovanni-Addolorata Hospital, Rome, Italy.
Omar ViswanathDepartment of Anesthesiology, Creighton University School of Medicine, Phoenix, AZ, USA.
Giustino VarrassiFondazione Paolo Procacci, Rome, 00193, Italy.
Matteo Luigi Giuseppe LeoniDepartment of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccidental dural puncture during epidural lead insertion for Spinal Cord Stimulation (SCS) is a recognized surgical complication that may lead to cerebrospinal fluid (CSF) leakage and subsequent postdural puncture headache (PDPH). The optimal technical approach to prevent CSF leakage remains controversial. This study aimed to evaluate a simple and efficient intraoperative technique for managing accidental dural puncture during SCS lead placement. MATERIALS AND

methodsA retrospective review was conducted of the medical records and imaging studies of all patients who underwent SCS procedures between January 2020 and April 2024. Signs or symptoms associated with dural puncture were recorded, including subcutaneous fluid collections, pseudomeningocele formation, PDPH, wound infection, and meningitis.

resultsAmong 107 patients who underwent SCS implantation, involving a total of 194 lead insertions, 4 cases (3.7%) of intraoperative CSF leakage due to iatrogenic dural puncture were identified. Each case was managed by injecting fibrin glue through the introducer needle into the epidural space, directly over the dural lesion.

conclusionsProphylactic application of fibrin glue following dural puncture appears to be highly effective in sealing the damage and preventing CSF leakage. This technique offers a valuable intraoperative solution for surgeons to immediately address dural injuries during SCS lead placement, potentially minimizing postoperative complications and improving patient outcomes.

Indexed as

Cerebrospinal Fluid LeakDura MaterFibrin Tissue AdhesiveIntraoperative ComplicationsPost-Dural Puncture HeadacheSpinal Cord StimulationAdultAgedElectrodes, ImplantedFemaleHumansMaleMiddle AgedRetrospective StudiesFibrin Tissue AdhesiveCSF leakageDural leakDural punctureDurotomy, repair techniqueSpinal cord stimulation

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.