BACKGROUND Epidural blocks are widely used for the management of acute and chronic pain. The technique of loss of resistance is frequently adopted to determine the epidural space. A discontinuity of the ligamentum flavum may increase the risk of failure to identify the epidural space. The purpose of this study was to investigate the anatomic variations of the cervical and high thoracic ligament...

We describe a rare case of vertebra (intraosseous) hemangioma with bilateral and symmetrical epidural extension causing cord compression in a 24-year-old woman. The epidural component was isointense to cord on both T1 and T2 sequences, and enhanced markedly and homogenously following gadolinium administration. The gradual in onset and progressive nature with the typical enhancing pattern lead t...

BACKGROUND AND OBJECTIVE Epidural injections in the lumbar spine are provided by caudal, lumbar interlaminar or transforaminal routes. Caudal epidural steroid injections are often used for low back pain. Fluoroscopic guidance has been frequently cited as a requirement for this procedure. In this case report, we demonstrate the importance of fluoroscopic guidance during caudal epidural injection...

Lidocaine in the epidural space, through inhibitory effects upon coagulation, may contribute to inefficacy of epidural autologous blood patch (EBP). This study was undertaken to evaluate the effect of achievable epidural concentrations of lidocaine on blood coagulation as a step in testing this hypothesis. Ex vivo blood coagulation using whole blood (n = 20) was studied with computerized thromb...

Performing lumbar epidural anaesthesia in children to provide analgesia in peri-operative period requires meticulous technique and have increased success rate if we can predict the distance from skin to posterior epidural space. The main purpose of this observational study is to measure skin to epidural distance (SED) in lumbar region in Indian children and to determine whether there is any cor...

BACKGROUND Continuous epidural analgesic infusions provide superior analgesia as compared to other forms of labor analgesia. However, inadequate analgesia after labor epidurals is not uncommon and has been found to be as high as 24% in some studies. The mechanism of these failures include inappropriate epidural catheter location, tissue compartmentalization within epidural space, delayed migrat...

Epidural neuroplasty (lysis of epidural adhesions) is an interventional technique that has emerged over the last 10 years as part of a multidisciplinary approach to treating radiculopathy with low back pain when conservative management has failed. Neuroplasty was at one time performed as a single-catheter technique using the caudal approach. It now has many variations, including placement of th...

We report a case of failed epidural anesthesia despite successful identification of the epidural space, loss of resistance technique, hanging drop method and drip infusion. This case evaluated the use of computed tomography to confirm epidural catheter position, which showed the catheter accidentally positioned at the T2 lamina. Because epidural anesthesia can even after successful procedure us...

Combined spinal epidural anesthesia is widely used for Caesarean section. Bolus administration of an epidural initial dose introduces the risk of drug flux from the epidural space to the subarachnoid space, and the volume effect of the initial dose may cause epidural top-up and extension of subarachnoid blockade. These problems may be avoided if the initial dose is not administered. This study ...

background & aim: although most patients experience severe pain after major spinal fixation surgery, little attention has been paid to control it with a multi-modal approach. the aim of this study is to select appropriate method of pain management after spinal surgery. methods & materials/patients: this study was a randomized clinically controlled trial in candidates of spondylolisthesis and sp...