Anesthesiologist Questions Lumbar Puncture (Spinal Tap)

I am having a painful sensation around my tailbone after a blood patch was done. What could be the reason?

I underwent a spinal tap test followed by a blood patch about two days later. I now have a swollen bump on my tailbone which is hurting a lot. While the doctor says there is nothing to worry about, I am still feeling unwell. What could be the reason for the same?

7 Answers

AnesthesiologistLumbarPuncture(SpinalTap)
Hello,

A blood patch procedure is used to stop fluid from leaking from inside the spinal canal. That part of the body is built like a bicycle tire. When the inner tube portion or the dura is punctured, fluid leaks and causes a headache when sitting or standing. A blood patch is performed by introducing a needle that enters the space just outside the inner tube, the epidural space. A person’s own blood is introduced into this space. The blood clots over the hole and prevents any further leakage. I cannot see how this procedure can be related to the tail bone. The epidural space does not extend that far down. It ends in the sacral region. I do not know if you had such a severe leak that it extended that far down, or so much fluid was injected that it extended that much. That bump should be monitored until it resolves.

Dr Ketch
I have performed many blood patches over the years, mainly for women experiencing epidural catheter placement and subsequent spinal headache. The only complication I have experienced is the failure of the blood patch to fix the headache. So, a second blood patch was done and would invariably fix the problem. The procedure has to be done in a sterile fashion and there is the risk of contamination. Anyone experiencing pain after a blood patch needs more evaluation.
Sometimes there could be some dull pain for a few days in the lower back after a blood patch. Anything beyond that I would recommend consulting your neurologist to determine the etiology of your pain.
I would think they are not related. The spinal and patch would be in the lower back, the lumbar area, which is too far removed from the coccyx area. You should simply monitor the tailbone area. If it doesn't get better in a few days or gets worse sooner, seek medical advice.
Hard to tell without looking at you, although this could be simply from pressure that is exerted by blood that they put in to perform a blood patch. It should resolve on its own, but if pain persists, you need to go back and address it.
You might have developed hematoma, get checked that is not the case.
It is unclear exactly where you are experiencing the pain. Typically the lumbar puncture would be down around the Lumbar 4-5 vertebrae which is close to the sacrum that some consider tail bone. A blood patch is used after cerebrospinal fluid leak. It normally takes care of headache and some back discomfort. If concerned and still having issues it is wise to ascertain a second opinion from a back specialist to exam you and if necessary perform imaging. Likely if no other symptoms if related the pain should improve.