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Schematic of DuraSeal dural sealant system assembly. Note. Omit step 7 as the spray tip is not needed for percutaneous injection of the hydrogel sealant. Instead attach the applicator directly to the Tuohy needle hub using the Luer lock mechanism.
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T10-T11 and T11-T12 was planned. The hydrogel sealant was prepared according to package insert instructions (Figure 1).
CT-guided image displaying the Tuohy needle trajectory to achieve right-sided transforaminal epidural placement for the injection of hydrogel sealant.
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Tuohy needle was used for transforaminal placement of the sealant at T10-T11 with the goal volume of 5 ml. The final needle tip location was placed slightly more ventral (Figure 2) compared to the initial injection at T11-12 as the dural defect had previously been identified to be more ventral in location.
Axial T2 postinjection MRI demonstrating extradural hydrogel sealant deposition with leftward displacement of the thecal sac and spinal cord at T10-11.
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T10-T11 level with normal cord signal (Figure 3). The patient subsequently developed signs and symptoms consistent with a concordant right-sided dermatomal thoracic neuralgia, presumably due to mass effect on the lower thoracic spinal nerve roots, but did not demonstrate any myelopathy.