PMC6607722_01
The MRI myelogram shows an abnormal fluid signal intensity in the left lumbar area, along the left paraspinal muscle and soft tissues at the L3-4-5 level, probably due to CSF leakage.
CRINM2019-1968314.001.jpg
PMC6607722_01_CRINM2019-1968314.001.jpg
fig1
The patient's postural headaches persisted for 4 days, so we decided to perform a transforaminal EBP at the L3-4 and 4-5 levels on the left side, the site of leakage in the MRI myelogram (Figure 1).
Fluoroscopic image of the epidural contrast injected through the left L3-4 and L4-5 foramens.
CRINM2019-1968314.002.jpg
PMC6607722_01_CRINM2019-1968314.002.jpg
fig2
Under fluoroscopic guidance, a 22-gauge needle (Hakko, Japan) was inserted with a transforaminal approach and then contrast was injected at the left L3-4 and L4-5 levels (Figure 2).