What to do when the needle encounters the bone during spinal or lumbar puncture

When you do the micro-redirections, what angle do you take, 5 degrees or so? And is there a limit to how many micro redirections you perform before taking out the needle and reassessing

Thank you very much!!!
Very precise and Informative.

This is so helpful!!! Thank you- Medical registrar from NZ :)

I finally understand the importance of this video, great job doctor!4

Multiple puncture sites! I have viewed several animations of this procedure. Something is wrong here. Could this procedure be updated? Ultrasound guidance or better as standard?
I researched this because a family member was administered incorrectly by a nurse causing possibly permanent nerve damage. She received compensation. She now has to live with Pregabalin pain drugs possibly for the rest of her life.

Thank you. Your video has been very much helpful

After diagnosis of IIH doctors operated my husband and put TP shunt in spine to stomach. After operation eyes reports are good and improving day by day but after 1 month the headache and blurring In vision is back and now it's almost 8 month completed.. bluring vision and headache are still there. I visited lots of nurosurgeon and Neurologist no one can fine the coz of pain. MRI and plapdema are normal in reports.. please help please give suggestions I'm from india

How to find spinous process in obese patients.. with alot of fat😢😢😢😢

Amazing explanation! Will definitely try it out and update..thanks for the video

this video is so advantage, thank you.

You are the best

Best way of explanation v informative ❤

👍🏼👍🏼👍🏼👍🏼👍🏼👍🏼

thanks to Dr. Hadzic for this excellent explanation about difficult spinal . But one point I may disagree. in my 38 years of anesthesia experience i did redirect the needle caudally too and I was successful .

Thank you for the tips! after watching this video, I went from getting 50% of my spinals to 100% of my spinals the very next day!

These tips are SO invaluable!!! THANK YOU!!!

Pray for me that m able to perform lumbar puncture, always unsuccessful 😢

Excellent sir...u r super man!!!

What an amazing explanation

This is one of the best clinical observations regarding spinal anaesthesia I've come across...Hats off to you sir for reading our minds and presenting solutions for it

Thanks bud. Much needed at a much vital time. Gratitude!!!

Thanks again.

wow 👌

Sir can you teach about spinal epidural hematoma

2 cm 6 cm 8 cm inside different scenarios, very beautifully explained

I was terrified to get an epidural (kinda still am) with my firstborn. The anesthesiologist I had seemed really strange and talked like some surfer dude, so I didn’t have a ton of confidence in him, but I was in such excruciating pain I felt like I needed it. The morphine given to me only lasted 10 minutes since they limit you due to baby. I had no idea or could tell that anything was hitting bone until the anesthesiologist said, “Oh, I’m hitting bone.” I tried to stay still as possible but in my mind I was like, “OMG WHAT?!”

My second epidural for my secondborn was much better and I felt way more relief from the meds. with that one. Not sure if she just did a better job or what.

Now I’m about to have my third baby and am nervous again for this. My mom knew someone she worked with back-in-the-day that had some kind of partial paralyzation from an epidural. I’ve heard they’ve improved at least since then but anything dealing with my spine makes me nervous!

The best teacher

😍😍😍

I am used to place he the nedle 5mm lateral left or right to the midline, keepin in mind to ad a small angel 5 degrees to the oposite side.
It is called the paraspinous or modified paramedial approach.
I have found that it reduces rate of failure and patient discomfort.

Thanks lot😅

I’m getting prolotherapy of the neck this week and I’m nervous 😅

i think whichever moron wrote this script doesn't quite understand what "augmented reality" is, even though the description is in the term itself.. so sad

Reading your book on nerve blocks... you're awesome man.

I was taught to do spinals in lateral decubitus position and also how to use paramedian approach. This way there is less bone obstruction and a wider window to the intrathecal space. An added benefit is that if patient feels faint they are already lying down. Also the level of block is easier to control with this approach. The bigger problem is when you can't feel a god damn thing because of body mass and have to guess where the midline is.

I just had hip replacement. There was a resident shadowing. Anesthesia "without asking me" let them try 4 TIMES and they still didn't get it. Anesthesia got it first try. I've had 3 others previously, no problems. I was pissed!

Thank you so much!

Excellent video ! Thank you for up it ! I wondering if in all your videos you can have one about difficult cannulation of AVGRAFT and old AV FISTULAS, For me, it has been a nightmare, THANK YOU SO MUCH!

I had 25 done to me and my back is messed up now I can't deal with it I'm trying to research lumber complications my back is messed up I can't stand straight

I have my LP done this Thursday But the headache is still bothering me whenever I stand up. It’s now Saturday. Any advice on what to do?

Thank you so much! 2/12/2024

How about when their pressure is too low and you get in two separate times are really for and they just won't give you any fluid

I guess the answer is due a third time. But there was a lot of blood in my samples, but I thought with a traumatic puncture that the blood would taper off, but it didn't it was in the same amount and all four tubes.

This isn't augmented reality 😂

During my planned c section spinal they were having issues getting it in (12 times!) I asked them if they need me to lean forward. They shouted at me and one came around and pushed me forward. Went straight in! Please don’t assume patients know when to lean forward. Speak to them and direct them 🥺

Side effect of the 3rd scenario?

❤

💯 recommend this video to anyone who needs a refresher on performing blocks 💯 success rate. Since watching this, I'm even able to perform a single attempt block for an elderly patient with lumbar scoliosis coming for hernia surgery where GA is not feasible.

Painful experience.

Amazing stuff

Thank you very much