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摘要

We appreciate the interest shown by Drs. Beriault and Korzeniewski in our recent ease report1 describing the use of the Tsui test to target placement of a thoracic epidural blood patch. These authors object to our expressed caution in entering the epidural space between T2 and T4, based on both their own extensive experience with high thoracic epidural placement, and their concern that the cited findings of failure of ligamentum flavum fusion in the midline reported by Lirk et al., may be an artifact of the embalming preparation. Our major objective in reporting this case was to demonstrate that it is possible to use the Tsui test to allow precise placement of a blood patch at a site distal from the entry point. Using this strategy, we were able to both circumvent the theoretical risks associated with high thoracic epidural entry, as well as confirm that the catheter placement is limited to the epidural space.