A Fluoroscopic Proof of No Cerebrospinal Fluid Flow during Spinal Anesthesia

Abstract

A spinal cord injured patient with obesity and deformed spine due to Gorham’s disease had been taken for a colostomy. We attempted spinal anesthesia under fluoroscopy to prevent autonomic hyperreflexia（AH）. In spite of adequate needle position in the spinal canal and sensation of dural puncture, no cerebrospinal fluid was seen and it was diagnosed as dry tap. Contrast medium was injected through the needle and we got findings of myelogram. After that, local anesthetic was injected. We could not confirm the level of anesthesia, but AH did not occur. When dry tap is identified, injection of local anesthetics is a possible choice that could result in optimal anesthesia.