No abstract available.
Epidural Space* ; Lymphoma* ; Sciatica

Although epidural block is a well-established anesthetic method, we often experience a failed epidural block. The success rate of epidural block is dependent on the accurate identification of the epidural space and successful location of the catheter within the epidural space. Rarely, it is missed to identify the epidural space with a loss of resistance method due to a variable anatomy of the epidural structure. Occasionally, an epidural catheter may pass into the extra-epidural space. We report 2 cases of misplacement of an epidural catheter in the extra-epidural space. These cases highlights the need for careful identification of the epidural space during epidural puncture and confirming the location for successful placement of the catheter within the epidural space by using a test block with a test dose of the local anesthetic drug after epidural catheterization.
Catheters ; Epidural Space ; Punctures

No abstract available.
Catheters* ; Epidural Space*

No abstract available.
Catheters* ; Epidural Space*

The use of fluoroscopy guidance together with the loss of resistance technique during epidural injections has been advocated lately; moreover, epidural injections in the absence of fluoroscopic guidance have a high rate of inaccurate needle-tip placement during the injections. However, the approach to the lower cervical and upper thoracic epidural space may be challenging due to its obscure lateral fluoroscopic views from overlying normal tissue structures. In this case, we report an alternative oblique C-arm fluoroscopy guided view approach to supplement the standard anterior-posterior and lateral fluoroscopic views to facilitate successful needle placement and precise anatomical localization of the epidural space.
Epidural Space ; Fluoroscopy ; Injections, Epidural ; Needles

The epidural blood patch is a relatively new technique for treatment of post spinal headache. Injection of autologous blood into the epidural space afforded prompt and permanent relief. "Pathcing" the dura hole with autologous blood is the most direct therapy available. It has always been used within a few days of development of headache. This procedure may be considered for patients who continue to experience in capacitating symptoms following a trial of supportive therapy. In our patient the epidural blood patch was used successfully on four cases after the development of headache.
Blood Patch, Epidural ; Epidural Space ; Headache* ; Humans

This article aims to study the factors affecting the flexibility of the tip of an epidural anesthesia catheter. The flexibility of the tip of the epidural anesthesia catheter was tested with a softness tester from four aspects:raw materials, tip structure, tip processing technology, and the outer diameter of the catheter. Highly flexible and malleable polymer material with a smooth tip, the tip softening process and the proper outer diameter can effectively improve the tip flexibility of the epidural anesthesia catheter.
Anesthesia, Epidural ; Catheterization ; Catheters ; Epidural Space

BACKGROUND: Neck flexion has been shown to increase cranial spread of contrast agent when a small fixed volume was injected into the high thoracic epidural space. The purpose of this study was to evaluate the effect of volume of contrast medium on its distribution through the high thoracic epidural space during neck extension and flexion using the rabbit model. METHODS: An epidural catheter was introduced into the epidural space of New Zealand white rabbits with the tip located at the T3-4 intervertebral level. The neck was extended or flexed (n = 8 for each group), and the contrast medium was injected with the volume increasing by increments of 0.1 ml/kg, up to 0.3 ml/kg. The spread of contrast medium was determined by counting the number of vertebral body units using lateral epidurographic images. RESULTS: In both groups, the total spread of contrast medium was similar, increasing continuously with injected volume. The cranial spread was greater in the flexion group than the extension group. However, the caudal spread was greater in the extension than in the flexion group. In the extension group, the contrast medium spread caudally about twice as far as it spread cranially, but there was no statistically significant difference between cranial and caudal spread in the flexion group. CONCLUSIONS: In the high thoracic epidural space of rabbit, the contrast medium of varying doses showed limited cranial spread. The flexion of the neck increased cranial spread and extension of the neck increased caudal spread.
Catheters ; Epidural Space ; Neck ; Rabbits

Cysticercosis of the central nerve system seldom involves spinal structures. When it does, the parasites grow much more often in the subarachnoid space than within the cord or epidural space. Recently we have experienced a cases of intramedullary cysticercosis in thoracic cord, which was characterized by paraparesis and voiding difficulty of 1 1/2 years duration in 34-year old man, and the patient's symptoms were improved after operation. We discuss this rare condition with brief review of the literature relevant to spinal cysticercosis.
Adult ; Cysticercosis* ; Epidural Space ; Humans ; Paraparesis ; Parasites ; Subarachnoid Space

OBJECTIVE: To observe the contrast spreading patterns in the retrodiscal (RD) approach for transforaminal epidural steroid injections and their effect on pain reduction. METHOD: Patients with L5 radiculopathy who were scheduled to receive lumbar TF-EPB were consecutively included. We randomly divided them into the L4-5 RD and L5-S1 RD groups and administered 1 cc of contrast dye into epidural space. We observed the shape and the location of contrast dye on the anterior-posterior and lateral views. We injected 1 cc of 0.5% lidocaine mixed with 20 mg of triamcinolone, and checked the pain intensity before and two weeks after the procedure by using visual analogue scale (VAS). RESULTS: In the L4-5 RD group (n=30), contrast spread over the L4 nerve root in 27 cases and the L4 and L5 nerve roots in 3 cases. In the L5-S1 RD group (n=33), contrast spread over the L5 nerve root in 20 cases, the S1 nerve root in 3 cases, and the L5 and the S1 nerve roots in 10 cases. The contrast spreading patterns could be divided into 4 patterns: the proximal root in 40 cases, the distal root in 19 cases, the anterior epidural space in 3 cases and an undefined pattern in 1 case. CONCLUSION: In RD lumbar TF-EPB, the contrast dye mostly went into the cephalic root and about 60% spread over the proximal nerve root. There was less pain reduction when the contrast dye spread over the distal nerve root.
Epidural Space ; Humans ; Lidocaine ; Radiculopathy ; Triamcinolone