Abstract
Despite the importance of anatomical knowledge in the safe and effective conduct of
thoraco-lumbar epidural anaesthesia there are widespread misunderstandings about the
detailed anatomy of this complex region. Current textbooks and teaching continue to
propagate misleading information.
Much of the difficulty in studying the lumbar epidural region is that the epidural
space is a ‘potential’ space occupying only a small volume at rest but capable of
expanding to accommodate large volumes of injected solution. This results in considerable
distortion during some anatomical studies. However new imaging and dissection techniques
have given us a much clearer insight into the anatomy and the relationships of the
dura, epidural fat, blood vessels and spinal canal.
This article seeks to provide an up-to-date account of current knowledge to give the
reader a clearer idea of the true anatomy and how it might influence their epidural
practice.
Keywords
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Article Info
Publication History
Royal College of Anaesthetists CPD Matrix: 2G02 3A09
Identification
Copyright
© 2012 Published by Elsevier Inc.
