Anesth Pain Med.  2018 Jul;13(3):314-318. 10.17085/apm.2018.13.3.314.

Post-dural puncture headache following acupotomy using “Wonli-acupuncture needle”: A case report

• Kim H
• Lee CH
• Kim YD

• KMID: 2436041
• DOI: http://doi.org/10.17085/apm.2018.13.3.314

Abstract

Acupuncture is a popular technique used worldwide, particularly for clinical pain management. Diverse methods of acupuncture with several types of needle have recently been introduced; however, medical evidence of the treatment and safety of many of these techniques has not been established. In addition, severe, life-threatening acupuncture-related complications have been reported even though the treatment is considered to be safe. We report a case of a post-dural puncture headache that occurred following acupuncture for the treatment of lower back pain, with a literature review. Pain physicians should consider that acupuncture can cause far more serious side effects than those previously known.

Keyword

Acupuncture; Post-dural puncture headache; Postoperative complications

MeSH Terms

Acupuncture
Low Back Pain
Needles
Pain Management
Post-Dural Puncture Headache*
Postoperative Complications

Figure

• 

  Fig. 1 Magnetic resonance imaging of the lumbar spine.

• 

  Fig. 2 Skin site of needle entry in acupotomy.

• 

  Fig. 3 Magnetic resonance myelography showing cerebrospinal fluid leakage in the lumbar spine.

• 

  Fig. 4 Brain magnetic resonance imaging.

• 

  Fig. 5 (A) Types of needle and (B) target points of acupotomy.

Reference

1. Kim YD, Moon HS. Review of medical dispute cases in the pain management in Korea: a medical malpractice liability insurance database study. Korean J Pain. 2015; 28:254–64. DOI: 10.3344/kjp.2015.28.4.254. PMID: 26495080. PMCID: PMC4610939.

2. Weinstein JN, Tosteson TD, Lurie JD, Tosteson AN, Blood E, Hanscom B, et al. Surgical versus nonsurgical therapy for lumbar spinal stenosis. N Engl J Med. 2008; 358:794–810. DOI: 10.1056/NEJMoa0707136. PMID: 18287602. PMCID: PMC2576513.

3. Kreiner DS, Shaffer WO, Baisden JL, Gilbert TJ, Summers JT, Toton JF, et al. An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis (update). Spine J. 2013; 13:734–43. DOI: 10.1016/j.spinee.2012.11.059. PMID: 23830297.

4. Kim HS, Kim SY, Kim HJ, Kim ES, Kim YI. The effect of acupotomy on lumbar herniated intervertebral disc: report of a case series. Acupuncture. 2015; 32:185–95. DOI: 10.13045/acupunct.2015050.

5. Lao L, Hamilton GR, Fu J, Berman BM. Is acupuncture safe?A systematic review of case reports. Altern Ther Health Med. 2003; 9:72–83. PMID: 12564354.

6. Derry CJ, Derry S, McQuay HJ, Moore RA. Systematic review of systematic reviews of acupuncture published 1996-2005. Clin Med (Lond). 2006; 6:381–6. DOI: 10.7861/clinmedicine.6-4-381.

7. Shui F, Lingyun G, Hongbo Z. Lumbar spinal stenosis clinical acupotomy therapy. Mod J Chinese Med. 2009; 18:1389–90.

8. Yuk DI, Kim KM, Jeon JH, Kim YI, Kim JH. A review of trends for acupotomy. Acupuncture. 2014; 31:35–43. DOI: 10.13045/acupunct.2014041.

9. Jo DJ, Lee BJ, Sung JK, Yi JW. Development of postdural puncture headache following therapeutic acupuncture using a long acupuncture needle. J Korean Neurosurg Soc. 2010; 47:140–2. DOI: 10.3340/jkns.2010.47.2.140. PMID: 20224715. PMCID: PMC2836451.

10. Lee GM, Lee EY, Han JH, Cho KH, Kang SR, Yoon SH. Effects of Wonli acupuncture procedure in patients with LSS: a clinical, retrospective study. Evid Based Complement Alternat Med. 2014; 2014:212098. DOI: 10.1155/2014/212098. PMID: 25045387. PMCID: PMC4090502.

11. Manchikanti L, Damron KS, Rivera JJ, McManus CD, Jackson SD, Barnhill RC, et al. Evaluation of the effect of sedation as a confounding factor in the diagnostic validity of lumbar facet joint pain: a prospective, randomized, double-blind, placebo-controlled evaluation. Pain Physician. 2004; 7:411–7. PMID: 16858481.

12. Ko MK, Kim JH, Hong KE. The study on post acupotomy headache. J Korean Acupunct Moxib Soc. 2010; 27:89–95.

13. Windsor RE, Storm S, Sugar R. Prevention and management of complications resulting from common spinal injections. Pain Physician. 2003; 6:473–83. PMID: 16871300.

14. Domenicucci M, Marruzzo D, Pesce A, Raco A, Missori P. Acute spinal epidural hematoma after acupuncture: personal case and literature review. World Neurosurg. 2017; 102:695e11–4. DOI: 10.1016/j.wneu.2017.03.125. PMID: 28377250.