epidural space

Summary

Summary: Space between the dura mater and the walls of the vertebral canal.

Top Publications

  1. Han K, Kim C, Park S, Kim J. Distance to the adult cervical epidural space. Reg Anesth Pain Med. 2003;28:95-7 pubmed
    ..Knowledge of the depth from the skin to the cervical epidural space (DSES) may be helpful when performing cervical epidural block and may reduce the possibility of complications...
  2. Aggarwal A, Kaur H, Batra Y, Aggarwal A, Rajeev S, Sahni D. Anatomic consideration of caudal epidural space: a cadaver study. Clin Anat. 2009;22:730-7 pubmed publisher
    ..7 (5.5) (range 58-78). The measurements described for the identification of the sacral hiatus, optimal angle of depression, and depth of the needle may improve the safety and reliability of a caudal epidural block...
  3. Uppal V, Kearns R, McGrady E. Evaluation of M43B Lumbar puncture simulator-II as a training tool for identification of the epidural space and lumbar puncture. Anaesthesia. 2011;66:493-6 pubmed publisher
    The identification of the epidural space, insertion of an epidural catheter and lumbar puncture are advanced technical skills that can be challenging to teach to novice anaesthetists...
  4. Faitot V, Ourchane R, Dahmani S, Magheru M, Nebout S, Gomas F, et al. An observational study of factors leading to difficulty in resident anaesthesiologists identifying the epidural space in obstetric patients. Int J Obstet Anesth. 2011;20:124-7 pubmed publisher
    ..The aim of this study was to evaluate the factors predicting difficult epidural analgesia for inexperienced residents...
  5. Rathmell J, Desjardins A, van der Voort M, Hendriks B, Nachabe R, Roggeveen S, et al. Identification of the epidural space with optical spectroscopy: an in vivo swine study. Anesthesiology. 2010;113:1406-18 pubmed publisher
    Accurate identification of the epidural space is critical for safe and effective epidural anesthesia or treatment of acute lumbar radicular pain with epidural steroid injections...
  6. Segal S, Arendt K. A retrospective effectiveness study of loss of resistance to air or saline for identification of the epidural space. Anesth Analg. 2010;110:558-63 pubmed publisher
    Randomized trials comparing air to saline for loss of resistance (LOR) for identification of the epidural space have suggested the superiority of saline...
  7. Schier R, Guerra D, Aguilar J, Pratt G, Hernandez M, Boddu K, et al. Epidural space identification: a meta-analysis of complications after air versus liquid as the medium for loss of resistance. Anesth Analg. 2009;109:2012-21 pubmed publisher
    The best method for identifying the epidural space for neuraxial blocks is controversial. We conducted this meta-analysis to test the hypothesis that loss of resistance with liquid reduces complications with epidural placement.
  8. Brummett C, Williams B, Hurley R, Erdek M. A prospective, observational study of the relationship between body mass index and depth of the epidural space during lumbar transforaminal epidural steroid injection. Reg Anesth Pain Med. 2009;34:100-5 pubmed publisher
    ..There are no published studies examining the depth of epidural space using a transforaminal approach...
  9. Balki M, Lee Y, Halpern S, Carvalho J. Ultrasound imaging of the lumbar spine in the transverse plane: the correlation between estimated and actual depth to the epidural space in obese parturients. Anesth Analg. 2009;108:1876-81 pubmed publisher
    ..In this study, we assessed prepuncture lumbar ultrasound scanning as a tool for estimating the depth to the epidural space and determining the optimal insertion point in obese parturients.

More Information

Publications62

  1. Chang S, Tsai M, Tsai M. An unusual primitive neuroectodermal tumor in the thoracic epidural space. J Clin Neurosci. 2010;17:261-3 pubmed publisher
    ..Our patient received surgery alone and, 1y ear later, has experienced no local recurrence within the epidural space but the mediastinal part of the tumor has enlarged.
  2. Ting C, Chang Y. Technique of fiber optics used to localize epidural space in piglets. Opt Express. 2010;18:11138-47 pubmed publisher
    ..reflectance spectra of ex-vivo porcine tissues, which are associated with the needle insertion to localize the epidural space (ES)...
  3. Wada N, Kohara M, Ikeda J, Hori Y, Fujita S, Okada M, et al. Diffuse large B-cell lymphoma in the spinal epidural space: A study of the Osaka Lymphoma Study Group. Pathol Res Pract. 2010;206:439-44 pubmed publisher
    Diffuse large B-cell lymphoma (DLBCL) involving spinal epidural space (SEDLBCL) is relatively rare, constituting 1.8% of DLBCLs in Osaka, Japan...
  4. Tao H, Fan H. Implantation of amniotic membrane to reduce postlaminectomy epidural adhesions. Eur Spine J. 2009;18:1202-12 pubmed publisher
    ..Various materials acting as mechanical barriers to reduce fibroblasts infiltration into epidural space have met with limited success...
  5. Eide P, Sorteberg W. Simultaneous measurements of intracranial pressure parameters in the epidural space and in brain parenchyma in patients with hydrocephalus. J Neurosurg. 2010;113:1317-25 pubmed publisher
    In this study, the authors compare simultaneous measurements of static and pulsatile pressure parameters in the epidural space and brain parenchyma of hydrocephalic patients.
  6. Grau T, Leipold R, Horter J, Conradi R, Martin E, Motsch J. Paramedian access to the epidural space: the optimum window for ultrasound imaging. J Clin Anesth. 2001;13:213-7 pubmed
    To establish a useful ultrasonic approach to the epidural space so as to optimize pre-puncture diagnostics.
  7. Huang H, He J, Herman R, Carhart M. Modulation effects of epidural spinal cord stimulation on muscle activities during walking. IEEE Trans Neural Syst Rehabil Eng. 2006;14:14-23 pubmed
    ..Stimulating electrodes were placed at the epidural space over T10-L2 spinal segments, along the midline in participant 1 (S1), and off-midline in participant 2 (S2)...
  8. Evron S, Gladkov V, Sessler D, Khazin V, Sadan O, Boaz M, et al. Predistention of the epidural space before catheter insertion reduces the incidence of intravascular epidural catheter insertion. Anesth Analg. 2007;105:460-4 pubmed
    ..On the basis of a pilot study and previous reports, we tested the hypothesis that predistention of the epidural space with saline before epidural catheterization would ease catheter insertion and decrease the incidence of this ..
  9. Poca M, Sahuquillo J, Topczewski T, Penarrubia M, Muns A. Is intracranial pressure monitoring in the epidural space reliable? Fact and fiction. J Neurosurg. 2007;106:548-56 pubmed
    ..have been attributed both to the characteristics of the sensor and to the particular anatomy of the epidural space. To determine which of these two possible causes better explains higher epidural readings, the authors ..
  10. van de Velde M. Identification of the epidural space: stop using the loss of resistance to air technique!. Acta Anaesthesiol Belg. 2006;57:51-4 pubmed
  11. Ichiyama R, Gerasimenko Y, Zhong H, Roy R, Edgerton V. Hindlimb stepping movements in complete spinal rats induced by epidural spinal cord stimulation. Neurosci Lett. 2005;383:339-44 pubmed
    ..Furthermore, the induced stepping patterns were dependent on sensory feedback associated with weight bearing...
  12. Aydin M, Sen O, Ozel S, Kayaselcuk F, Caner H, Altinors N. Primary primitive neuroectodermal tumor within the spinal epidural space: report of a case and review of the literature. Neurol Res. 2004;26:774-7 pubmed
    ..Tumors within the epidural space of the spinal canal are most often metastatic neoplasms from different primary sites...
  13. Minassian K, Jilge B, Rattay F, Pinter M, Binder H, Gerstenbrand F, et al. Stepping-like movements in humans with complete spinal cord injury induced by epidural stimulation of the lumbar cord: electromyographic study of compound muscle action potentials. Spinal Cord. 2004;42:401-16 pubmed
    ..demonstrated that sustained nonpatterned electric stimulation of the posterior lumbar spinal cord from the epidural space can induce stepping-like movements in subjects with chronic, complete spinal cord injury...
  14. Lechner T, van Wijk M, Maas A, van Dorsten F, Drost R, Langenberg C, et al. Clinical results with the acoustic puncture assist device, a new acoustic device to identify the epidural space. Anesth Analg. 2003;96:1183-7, table of contents pubmed
    ..for lumbar epidural anesthesia were included in a study in which we evaluated the efficacy of localizing the epidural space by means of an acoustic signal...
  15. Beilin Y, Arnold I, Telfeyan C, Bernstein H, Hossain S. Quality of analgesia when air versus saline is used for identification of the epidural space in the parturient. Reg Anesth Pain Med. 2000;25:596-9 pubmed
    Identification of the epidural space is often performed using the loss-of-resistance technique (LOR), commonly with air or saline. The effect of air or saline on the quality of labor epidural analgesia has not been adequately studied.
  16. Ames W, Hayes J, Petroz G, Roy W. Loss of resistance to normal saline is preferred to identify the epidural space: a survey of Canadian pediatric anesthesiologists. Can J Anaesth. 2005;52:607-12 pubmed
    Several methods have been described to locate the epidural space, but the loss-of-resistance (LOR) technique is the most commonly used. Expert opinion states that LOR to air is the best medium for neonates and infants...
  17. Lechner T, van Wijk M, Maas A. Clinical results with a new acoustic device to identify the epidural space. Anaesthesia. 2002;57:768-72 pubmed
    ..under lumbar epidural anaesthesia were included in a study to evaluate the possibility of localising the epidural space solely by means of an acoustic signal...
  18. Ogose A, Hotta T, Inoue Y, Sakata S, Takano R, Yamamura S. Myxoid liposarcoma metastatic to the thoracic epidural space without bone involvement: report of two cases. Jpn J Clin Oncol. 2001;31:447-9 pubmed
    ..We present two cases of myxoid liposarcoma metastatic to the epidural space. Both patients complained of back pain, but plain radiography revealed no abnormality...
  19. Shiroyama K, Izumi H, Kubo T, Nakamura R. Distance from the skin to the epidural space at the first lumbar interspace in a Japanese obstetric population. Hiroshima J Med Sci. 2003;52:27-9 pubmed
    We prospectively examined the distance from the skin to the epidural space (SE distance) in 95 Japanese parturient women who underwent epidural anesthesia at the L1-2 interspace, and studied the correlation between various physical ..
  20. Tsui B, Wagner A, Finucane B. The threshold current in the intrathecal space to elicit motor response is lower and does not overlap that in the epidural space: a porcine model. Can J Anaesth. 2004;51:690-5 pubmed
    ..a current of 1 to 10 mA is required to confirm the presence of the tip of an epidural catheter in the epidural space. The purpose of this study was to examine the hypothesis that the threshold current required to elicit a motor ..
  21. Grau T, Leipold R, Horter J, Conradi R, Martin E, Motsch J. The lumbar epidural space in pregnancy: visualization by ultrasonography. Br J Anaesth. 2001;86:798-804 pubmed
    ..0-MHz curved array probe. We measured two distances from the skin to the epidural space: the minimum (perpendicular) and the maximum (oblique) needle trajectory...
  22. Igarashi T, Hirabayashi Y, Shimizu R, Saitoh K, Fukuda H, Suzuki H. The fiberscopic findings of the epidural space in pregnant women. Anesthesiology. 2000;92:1631-6 pubmed
    ..Changes in the epidural structure during pregnancy may affect the spread of analgesia in pregnant women. To investigate the changes in the epidural space produced by pregnancy, the authors performed epiduroscopy in pregnant women.
  23. Newell R. The spinal epidural space. Clin Anat. 1999;12:375-9 pubmed
    ..It is suggested that the spinal epidural space satisfies the criteria of Haines (1991) to be considered a "true potential space...
  24. Clinkscales C, Greenfield M, Vanarase M, Polley L. An observational study of the relationship between lumbar epidural space depth and body mass index in Michigan parturients. Int J Obstet Anesth. 2007;16:323-7 pubmed
    ..The aim of this study was to characterize the relationship between lumbar epidural space depth and body mass index in United States parturients from Michigan.
  25. Grau T, Leipold R, Delorme S, Martin E, Motsch J. Ultrasound imaging of the thoracic epidural space. Reg Anesth Pain Med. 2002;27:200-6 pubmed
    ..the "loss of resistance" technique is the standard technique for the identification of the epidural space (EDS), the feedback to the operator is often solely tactile...
  26. Hamid M, Fallet Bianco C, Delmas V, Plaisant O. The human lumbar anterior epidural space: morphological comparison in adult and fetal specimens. Surg Radiol Anat. 2002;24:194-200 pubmed
    To increase our understanding of the clinical anatomy of the epidural space, the human lumbar anterior epidural space was studied morphologically and developmentally...
  27. Krishnam -, Mallick A. Air in the epidural space leading to a neurological deficit. Anaesthesia. 2003;58:292-3 pubmed
  28. Lavrov I, Courtine G, Dy C, van den Brand R, Fong A, Gerasimenko Y, et al. Facilitation of stepping with epidural stimulation in spinal rats: role of sensory input. J Neurosci. 2008;28:7774-80 pubmed publisher
    ..These data suggest that facilitation of stepping with epidural stimulation is mediated primarily through ipsilateral afferents that project to the locomotor networks...
  29. Ruetten S, Meyer O, Godolias G. Endoscopic surgery of the lumbar epidural space (epiduroscopy): results of therapeutic intervention in 93 patients. Minim Invasive Neurosurg. 2003;46:1-4 pubmed
    ..Epiduroscopy is available for visualization of the lumbar epidural space. 93 patients with chronic back-leg pain syndrome were epiduroscopically operated...
  30. Lee C, Jeon Y, Lim Y, Bahk J, Kim Y, Lee S, et al. The influence of neck flexion and extension on the distribution of contrast medium in the high thoracic epidural space. Anesth Analg. 2007;104:1583-6, table of contents pubmed
    ..In this study, we observed the distribution of contrast injected into the high thoracic epidural space during neck flexion and extension.
  31. Bozkurt G, Ayhan S, Turk C, Akbay A, Soylemezoglu F, Palaoglu S. Primary extraosseous Ewing sarcoma of the cervical epidural space. Case illustration. J Neurosurg Spine. 2007;6:192 pubmed
  32. Eide P. Comparison of simultaneous continuous intracranial pressure (ICP) signals from ICP sensors placed within the brain parenchyma and the epidural space. Med Eng Phys. 2008;30:34-40 pubmed
    ..Codman ICP MicroSensor; Johnson & Johnson, Raynham, MA) placed within the brain parenchyma and the epidural space were compared in ten patients with idiopathic normal pressure hydrocephalus (iNPH)...
  33. Jilge B, Minassian K, Rattay F, Pinter M, Gerstenbrand F, Binder H, et al. Initiating extension of the lower limbs in subjects with complete spinal cord injury by epidural lumbar cord stimulation. Exp Brain Res. 2004;154:308-26 pubmed
    ..In the electromyograms of the lower-limb muscle groups, such activity is reflected as a characteristic spatiotemporal pattern of compound motor-unit potentials...
  34. Annertz M, Jonsson B, Strömqvist B, Holtas S. No relationship between epidural fibrosis and sciatica in the lumbar postdiscectomy syndrome. A study with contrast-enhanced magnetic resonance imaging in symptomatic and asymptomatic patients. Spine (Phila Pa 1976). 1995;20:449-53 pubmed
    ..Symptomatic patients were retrospectively analyzed and compared with a control group from an ongoing prospective and consecutive study...
  35. Lee I, Yamagishi N, Oboshi K, Yamada H. Effect of epidural fat on xylazine-induced dorsolumbar epidural analgesia in cattle. Vet J. 2003;165:330-2 pubmed
  36. Perry M, Billars L. Extravasation of hyperalimentation into the spinal epidural space from a central venous line. Neurology. 2006;67:715 pubmed
  37. Kao M, Tsai S, Chang W, Liu H, Hsieh Y, Hu J, et al. Prediction of the distance from skin to epidural space for low-thoracic epidural catheter insertion by computed tomography. Br J Anaesth. 2004;92:271-3 pubmed
    It may be clinically useful to predict the depth of the epidural space.
  38. Carhart M, He J, Herman R, D Luzansky S, Willis W. Epidural spinal-cord stimulation facilitates recovery of functional walking following incomplete spinal-cord injury. IEEE Trans Neural Syst Rehabil Eng. 2004;12:32-42 pubmed
    ..Confirmation of these promising results in a controlled study of groups of spinal-cord-injured subjects is warranted...
  39. Lee I, Yamagishi N, Oboshi K, Yamada H. Distribution of new methylene blue injected into the lumbosacral epidural space in cats. Vet Anaesth Analg. 2004;31:190-4 pubmed
    To determine the effects of injection volume and vertebral anatomy on the spread of new methylene blue (NMB) injected into the lumbosacral epidural space in cats.
  40. Izycka Swieszewska E, Stefanowicz J, Debiec Rychter M, Rzepko R, Borowska Lehman J. Peripheral primitive neuroectodermal tumor within the spinal epidural space. Neuropathology. 2001;21:218-21 pubmed
    ..The present case emphasizes the usefulness of FISH in differential diagnosis of tumors, especially when only routinely fixed material is available...
  41. Turgut M, Baka M, Yurtseven M. Metastatic Merkel cell carcinoma to the sacrum and epidural space: case report. Magn Reson Imaging. 2004;22:1340 pubmed
  42. Goel A, Pollan J. Contrast flow characteristics in the cervical epidural space: an analysis of cervical epidurograms. Spine (Phila Pa 1976). 2006;31:1576-9 pubmed
    ..A single-center prospective analysis of cervical epidurograms, using a crossover design...
  43. Rönnberg K, Lind B, Zoega B, Gadeholt Gothlin G, Halldin K, Gellerstedt M, et al. Peridural scar and its relation to clinical outcome: a randomised study on surgically treated lumbar disc herniation patients. Eur Spine J. 2008;17:1714-20 pubmed publisher
    ..Further, no positive or negative effects of ADCON-L used in disc herniation surgery could be seen...
  44. Denaro V, Di Martino A, Longo U, Costa V, Papalia R, Forriol F, et al. Effectiveness of a mucolythic agent as a local adjuvant in revision lumbar spine surgery. Eur Spine J. 2008;17:1752-6 pubmed publisher
  45. Habib A, George R, Allen T, Olufolabi A. A pilot study to compare the Episure Autodetect syringe with the glass syringe for identification of the epidural space in parturients. Anesth Analg. 2008;106:541-3, table of contents pubmed publisher
    ..pilot study, we compared the spring-loaded syringe with the standard glass syringe for identification of the epidural space during initiation of epidural analgesia in parturients...
  46. Riley E, Carvalho B. The Episure syringe: a novel loss of resistance syringe for locating the epidural space. Anesth Analg. 2007;105:1164-6, table of contents pubmed
    ..This syringe supplies a constant pressure while the operator is advancing the Tuohy needle...
  47. Sekhar L, Natarajan S, Manning T, Bhagawati D. The use of fibrin glue to stop venous bleeding in the epidural space, vertebral venous plexus, and anterior cavernous sinus: technical note. Neurosurgery. 2007;61:E51; discussion E51 pubmed
    Various techniques have been used to stop venous bleeding from the epidural space, vertebral venous plexus, and cavernous sinus. Here, we describe our experience with the use of fibrin glue to stop venous bleeding in these areas.
  48. Gerasimenko Y, Roy R, Edgerton V. Epidural stimulation: comparison of the spinal circuits that generate and control locomotion in rats, cats and humans. Exp Neurol. 2008;209:417-25 pubmed
    ..g., serotonergic agonists, and/or chronic step training also are described. Finally, a major point emphasized in this review is the striking similarity of the lumbosacral circuitry controlling locomotion in the rat and in the human...
  49. Viesca C, Racz G, Day M. Special techniques in pain management: lysis of adhesions. Anesthesiol Clin North America. 2003;21:745-66, vi pubmed
    ..To enhance treatment outcome, an understanding of the pathophysiology of the underlying pain and the design of target-specific treatment modalities is important...
  50. Lee I, Yamagishi N, Oboshi K, Yamada H, Ohtani M. Multivariate regression analysis of epidural pressure in cattle. Am J Vet Res. 2002;63:954-7 pubmed
    ..To evaluate the effects of growth, maturity, and pregnancy on epidural pressure in cattle...
  51. Vanicky I, Urdzikova L, Saganová K, Cizkova D, Galik J. A simple and reproducible model of spinal cord injury induced by epidural balloon inflation in the rat. J Neurotrauma. 2001;18:1399-407 pubmed
    ..A 2-French Fogarty catheter is inserted into the dorsal epidural space through a small hole made in T10 vertebral arch, advanced cranially to T8-9 spinal level, and inflated for 5 ..
  52. Lennox P, Umedaly H, Grant R, White S, Fitzmaurice B, Evans K. A pulsatile pressure waveform is a sensitive marker for confirming the location of the thoracic epidural space. J Cardiothorac Vasc Anesth. 2006;20:659-63 pubmed
    ..The purpose of this study was to assess the validity of using a pulsatile, pressure waveform transduced from the epidural space through an epidural needle or catheter to confirm correct placement for maximal analgesia and to compare 3 ..
  53. Grau T, Leipold R, Conradi R, Martin E, Motsch J. [Ultrasonography and peridural anesthesia. Technical possibilities and limitations of ultrasonic examination of the epidural space]. Anaesthesist. 2001;50:94-101 pubmed
    ..offers the possibility to determine site and direction of epidural puncture and distance of the epidural space to the skin even before the puncture attempt...