Abstract
Background & Objectives: Although serious complications associated with massage are few, spinal manipulation in neck massage has repeatedly been associated with serious complications. To date, spontaneous intracranial hypotension (SIH) secondary to neck massage has rarely been reported. In the present study, we reported our experience in treating SIH secondary to neck massage with epidural blood patch (EBP) and evaluated the treatment efficacy. Materials & Methods: We retrospectively reviewed a cohort of 189 SIH patients diagnosed and treated with targeted EBP after identification of CSF leak via CT myelography or MR myelography in our institution.Patients who developed SIH after neck massage and were refractory to conservative treatment (bed rest and overhydration) of at least two weeks were included. Results: A series of nine cases of SIH secondary to neck massage who were treated with EBP were evaluated. A significant recovery was obtained in all nine patients after once (n=7) and twice(n=2) targeted EBP. No serious complications related to EBP occurred. Conclusion:Neck massage can cause a dural tear and subsequently spontaneous intracranial hypotension.Targeted EBP is a rational choice for treatment of refractory SIH secondary to neck massage after the identification of CSF leakage with CT myelography or MR myelography.
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