Spinal flexion and CSF pressure

Résumé fourni par la source

The paper by Dinsmore et al. (Anaesthesia 1998; 53: 431–4) shows that flexion of the spine decreases the capacity of the cerebrospinal fluid (CSF) space and increases the CSF pressure. Figure 1 in their paper shows an increase in CSF pressure with increasing flexion of the spine. However, in their summary and paragraph one of the discussion, they erroneously state that the CSF pressure increased from the fully flexed to the flexed position. This should read ‘the CSF pressure decreased from the fully flexed to the flexed position’. They found a mean increase of 5.3 mmHg in CSF pressure when patients moved from the flexed to the fully flexed position. The maximum increase in CSF pressure they recorded was 11 mmHg. With these results they conclude that epidural puncture performed in a fully flexed position may increase the incidence of inadvertent dural puncture. However, when moving from lateral to the sitting position, the mean CSF pressure increases by 28 mmHg [1]. Yet with this greatly increased CSF pressure, there is no evidence that epidural puncture performed in the sitting position carries a greater risk of inadvertent dural puncture.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.