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An epidural blood patch (EBP) is a surgical procedure that uses autologous blood, meaning the patient's own blood, in order to close one or many holes in the dura mater of the spinal cord, which occurred as a complication of a lumbar puncture or epidural placement. [1] [2] The punctured dura causes cerebrospinal fluid leak (CSF leak). [1]
A spontaneous spinal CSF leak refers to any CSF leak that has not been preceded by a surgical or other medical procedure. [ 12 ] [ 29 ] [ 37 ] Later evidence suggests that these leaks result from either a discogenic pathology, such as microspur, osteophyte or spinal disc herniation that pierces the dura like a knife, connective tissue disorder ...
The CPT code revisions in 2013 were part of a periodic five-year review of codes. Some psychotherapy codes changed numbers, for example 90806 changed to 90834 for individual psychotherapy of a similar duration. Add-on codes were created for the complexity of communication about procedures.
For this procedure, there are two ways to start: with a free graft repair or with a vascularized flap repair. The free grafts use secondary material like cadaver flaps or titanium mesh to repair the skull base defects, which is very successful (95% without CSF leaks) with small CSF fistulas or small defects. [12]
Open reduction and internal fixation (ORIF) is a surgical term that refers to open surgical repair of broken bones. It is required for correction of complex Le Fort fractures affecting facial function or involving neurological complications (visual changes, CSF leak). [6]
Traumatic CSF rhinorrhoea is the most common type of CSF rhinorrhoea. [1] It may be due to severe head injury, or from complications from neurosurgery. [1] Spontaneous CSF rhinorrhoea is the most common acquired defect in the skull base bones (anterior cranial fossa) causing spontaneous nasal liquorrhea.
A headache that is persistent despite a long period of bedrest and occurs only when sitting up may be indicative of a CSF leak from the lumbar puncture site. It can be treated by more bedrest, or by an epidural blood patch , where the person's own blood is injected back into the site of leakage to cause a clot to form and seal off the leak.
Healthcare Common Procedure Coding System (including Current Procedural Terminology) (for outpatient use; used in United States) ICD-10 Procedure Coding System (ICD-10-PCS) (for inpatient use; used in United States) ICD-9-CM Volume 3 (subset of ICD-9-CM) (formerly used in United States prior to the introduction of the ICD-10-PCS)