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Disc Damage
April 2003

Q. Nine months ago I had a baby. During the epidural, I had a dural puncture and subsequent blood patch. The day after the puncture, but before the blood patch, an injection of saline into the dural space caused such back pain that I was unable to move for approximately 10 minutes. The excruciating pain eventually was eased by a bombardment of pain medication and time.

Now, suddenly I am having incredible back problems and a recent MRI has diagnosed a bulging disk. Could the dural puncture, saline injection or blood patch have caused any disk damage?

A. The epidural anesthetic is commonly used during childbirth and other surgical procedures. It places drugs to block pain in the epidural sac which is separate but surrounding the spinal cord and nerves. The risk of complication is low, but significant problems can occur.

If the dural sac is punctured, a leak of CSF (cerebrospinal fluid) occurs which can cause severe headache and back pain. Small leaks usually resolve over time, but in severe cases a blood patch is attempted to seal the leak.

I am not sure about the role of the saline injection you describe. With the abnormalities now seen on the MRI, you should have a consultation with a spine specialist. This may be an orthopedist, neurosurgeon, or physiatrist. Your family doctor can make the needed referral.



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