The Lumbar Epidural Space in Patients Examined with Epiduroscopy

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Abstract
Ght subjects. The extent of view was very limited. The epidural space opened up only temporarily as air was injected. The dura mater lay very close to the dorsal aspect of the epidural space and was attached to the flaval ligaments by a dorsomedian connective tissue band. The band was identified in all eight subjects and was found to cause a dorsal fold in the dura mater. An epidural catheter was introduced 2-5 cm into the space by midline puncture in four patients and by the paramedian approach in the other four. The catheter was visualized in two patients only when the paramedian approach was used. None of the midline catheters could be seen in the space. In 2 of the 10 subjects a moderate bleeding impaired the view and made complete examination impossible. Smaller bleeding occurred in three other subjects. The partial laminectomy performed one to two interspaces caudad to the level of endoscopy did not reveal any evidence of epidural bleeding in any subject. The postoperative course of all patients was uneventful. Presented in part at the 19th Congress of the Scandinavian Society of Anaesthesiologists in Linkoping, July 2, 1987. Supported by grants from the Swedish Society of Medicine, the Fredga Research Foundation, the County Council of Östergötland, and by Astra Läkemedel AB. Received from the Departments of Anesthesia and of Orthopedic Surgery, Central Hospital, Norrköping, Sweden in affiliation with the Department of Anesthesiology, University Hospital, Linköping, Sweden. Accepted for publication July 11, 1988. Address correspondence to: Dr. Blomberg, Department of Anesthesia, Central Hospital, S-601 82 Norrköping, Sweden. © 1989 International Anesthesia Research Society...

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