Summary AND Conclusions
When used in performing a spinal tap, the conventional 22-gauge spinal needle produces cores of skin or threads of epidermis in 75 per cent of cases. Most of the fresh cores are sucked into the syringe during the test aspiration of the spinal fluid, and some of them may be re-injected into the subarachnoid space with the potential hazards of septic or chemical contamination.
When the available clinical surveys are analyzed in the light of these facts, the incidence of postspinal headache appears to be related not only to the gauge of the needle but also to its capacity for coring, and this possible aetiology is presented as an alternate hypothesis.
Résumé
Lorsqu’on procède a une ponction spinale, dans 75 pour cent des cas, l’aiguille ordinaire de calibre 22 produit des bouchons de peau ou des filaments d’épiderme. La plupart des bouchons frais sont attirés dans la seringue lorsqu’on aspire du liquide céphalorachidien, et quelques uns peuvent être réinjectés dans l’espace sous-arachnoïdien, ce qui risque d’engendrer une contamination septique ou chimique.
A la lumière de ces faits, en analysant les études cliniques dont on dispose, il semble que la céphalée post-rachidienne soit en rapport non seulement avec le calibre de l’aiguille mais aussi avec son pouvoir de produire un bouchon, et cette étiologie possible est présentée comme une hypothèse plausible.
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Brandus, V. The spinal needle as a carrier of foreign material. Can. Anaes. Soc. J. 15, 197–201 (1968). https://doi.org/10.1007/BF03005726
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DOI: https://doi.org/10.1007/BF03005726