Fluoroscopic-guided paramedian approach to subarachnoid block in patients with ankylosing spondylitis: A case series.

Experimental and clinical studies have suggested a lower CSF pressure in the prone position.[ 9 10 ] The lower incidence of post-dural puncture headache observed after surgeries in prone position has also been hypothesised to a lower CSF pressure and lesser CSF leak in the prone position.[ 9 ] A comparison of CSF opening pressure in patients undergoing fluoroscopic-guided lumbar puncture in prone versus lateral position, found the mean pressure to be 1.2 cm H 2 O lower in the prone position; however, the results failed to reach statistical significance.[ 10 ] It is therefore prudent to wait for the passive return of CSF after perceiving the loss of resistance to avoid unnecessary deeper advancement of the needle.

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