The way to bend the dura

(1) Transsacral puncture method: the patient was placed in prone position and the skin was routinely disinfected. After local anesthesia, a 16-gauge epidural needle was used to Pierce the sacrococcygeal ligament at a 45 degree Angle to the trunk, and then slowly penetrated the sacral canal at a 25 degree Angle. As the subarachnoid space terminated at the plane of the second sacral vertebra, the puncture needle should not exceed this plane to ensure that it would not penetrate into the subarachnoid space. The needle core was pulled out to observe whether cerebrospinal fluid was spilt. The epidural anesthesia catheter was inserted into the lumbosacral epidural space, and then the puncture needle was withdrawn. Before contrast medium injection, 80 ~ 120ml of 0.5% procaine can be injected to observe the presence of spinal anesthesia to rule out penetrating dural injury. Contrast media should not be injected until there is no dural injury. (2) Lumbar puncture retrodural angiography: the patient is placed in lateral decubitus position, with the affected side below and the head slightly elevated. Methods Puncture was performed from lumbar 3, lumbar 4 space with epidural anesthesia. After confirming that the needle tip was in the epidural space, contrast medium was slowly injected, and the needle was removed and radiographs were taken. (3) Translumbar puncture predural angiography: The patient was placed in lateral decubitus position, and a 22-gauge puncture needle was inserted through the spines of lumbar 4 and lumbar 5. When the tip of the needle breaks through the posterior arachnoid wall into the subarachnoid space, there is cerebrospinal fluid outflow, and the needle continues to puncture forward. When the tip penetrates into the predural space, there is no cerebrospinal fluid outflow. The X-ray film was taken to confirm that the tip of the needle was at the posterior edge of the vertebral body, and 2ml of 0.5% procaine was injected. If there was no resistance, 2ml of contrast medium could be injected. After the X-ray film was taken to confirm that no contrast medium spilled into the subarachnoid space, 4ml of contrast medium was injected and the puncture needle was pulled out. Epidural angiography can show the size of the spinal canal, disc herniation outside of the dural sac. It has a high accuracy in the diagnosis of lumbar disc herniation, but due to the amount of fat, loose connective tissue and venous plexus in the epidural space of the spinal canal, it affects the display of spinal canal contour image. A combination of anteroposition and lateral analysis is necessary during reading.

If you have any questions, please contact us. Our company can produce various customized needles, medical needles, puncture needles, hypodermic needles, biopsy needles, vaccine needles, injection needles, syringe needles, veterinary needles, pencil point needle, ovum pick up needles, spinal needles, etc. If you need customized needle products, please contact us. We look forward to your inquiry! The quality of the products manufactured in our factory will surely satisfy you!

Please contact us if you need: zhang@sz-manners.com