THE TOPOGRAPHICAL ANATOMY OF THE LUMBAR EPIDURAL SPACE

  • 1 January 1985
    • journal article
    • research article
    • Vol. 141  (AUG) , 211-217
Abstract
Although clinically important, the lumbar epidural space is inconsistently described in textbooks of both anatomy and anesthetics. This anatomical study on 12 cadavers was performed to clarify the description of this region. The dura mater, which possesses a midline fold in very few cases, is apposed to the walls of the vertebral canal, and attached to them by connective tissue. The connections are stronger anteriorly and weaker posteriorly and are sufficient to allow for displacement of the dural sac during movement of the spinal canal and engorgement of the vertebral venous plexus. Between the dura mater and the vertebral canal is a thin layer of areolar tissue. This contains the internal vertebral venous plexus and a posterior deposit of fat which lies in a recess between the ligamenta flava. Fat is also found in the intervertebral foramina, but did not fill the whole of the epidural space. These findings are discussed in relation to previous studies to arrive at a cohesive description of the epidural region.