Skip to main content
SpringerLink
Log in

Anatomy of the Lumbar Epidural Region

  • Chapter
  • First Online:
Epidural Technique In Obstetric Anesthesia

  • 706 Accesses

Abstract

Vertebral lumbar column anatomy and its attachments must be well known in order to have a mental picture of the course the needle should take during lumbar puncture.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Zarzur E. Anatomic studies of the human lumbar ligamentum flavum. Anesth Analg. 1984;63:499–502.

    Article  CAS  Google Scholar 

  2. Lirk P, Moriggl B, Colvin J, et al. The incidence of lumbar ligamentum flavum midline gaps. Anesth Analg. 2004;98:1178–80.

    Article  Google Scholar 

  3. Reina M, Lirk P, Sàncez AP, et al. Human lumbar ligamentum flavum anatomy for epidural anesthesia. Reviewing a 3D MR-based interactive model and postmortem samples. Anesth Analg. 2016;122:903–7.

    Article  CAS  Google Scholar 

  4. Nachemson AL, Evans JH. Some mechanical properties of the third human lumbar interlaminar ligament (ligamentum flavum). J Biomech. 1968;3:211–4.

    Article  Google Scholar 

  5. Yahia LH, Garzon S, Strykowski H, et al. Ultrastructure of the human interspinous ligament and ligamentum flavum. A preliminary study. Spine. 1990;15:262–8.

    Article  CAS  Google Scholar 

  6. Altinkaia N, Yldirim T, Demir S, et al. Factors associated with the thickness of the ligamentum flavum: is ligamentum flavum thickening due to hypertrophy or buckling? Spine. 2011;36(16):E1093–7.

    Article  Google Scholar 

  7. Kolte VS, Kambatta S, Ambiye MV. Thickness of the ligamentum flavum: correlation with age and its asymmetry. A magnetic resonance imaging study. Asian Spine J. 2014;9:245–53.

    Article  Google Scholar 

  8. Johnson GM, Zhang M. Regional differences within the human supraspinous and interspinous ligaments: a sheet plastination study. Eur Spine J. 2002;11:382–8.

    Article  Google Scholar 

  9. Jang D, Seoungwoo P. A morphometric study of the lumbar interspinous space in 100 Stanford University Medical Center patients. J Korean Neurosurg Soc. 2014;55:2661–266.

    Google Scholar 

  10. Lonneman ME, Paris SV, Gorniak GC. A morphological comparison of the human lumbar multifidus by chemical dissection. J Man Manip Ther. 2013;16(4):E84–92. https://doi.org/10.1179/jmt2008.16.4.84E.

    Article  Google Scholar 

  11. Amonoo-Kuofi HA, El-Badawi M, Fatani J. Ligaments associated with lumbar intervertebral foramina. L1 to L4. J Anat. 1988;156:177–83.

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Amonoo-Kuofi HA, El-Badawi M, Fatani J, et al. Ligaments associated with lumbar intervertebral foramina. The fifth lumbar level. J Anat. 1988;159:1–10.

    CAS  PubMed  PubMed Central  Google Scholar 

  13. Reina MA, Franco CD, Lòpez A, et al. Clinical implications of epidural fat in the spinal canal. A scanning electron microscopic study. Acta Anaesthesiol Belg. 2009;60:7–17.

    CAS  PubMed  Google Scholar 

  14. Reina MA, Pulido P, Casteldo J, et al. Characteristics and distribution of normal human epidural fat. Rev Esp Anestesiol Reanim. 2006;53:363–72. (in Spanish).

    CAS  PubMed  Google Scholar 

  15. Beaujeux R, Wolfram-Gabel R, Kehrli P, et al. Posterior lumbar epidural fat as a functional structure? Spine. 1997;22:1264–9.

    Article  CAS  Google Scholar 

  16. Wolfram-Gabel R, Beaujeux R, Fabre M, et al. Histologic characteristics of posterior lumbar epidural fatty tissue. J Neuroradiol. 1996;23:19–25.

    CAS  PubMed  Google Scholar 

  17. Wiltse L, Fonseca A, Amster J, et al. Relationship of the dura, Hofmann’s ligaments, Baston’s plexus and a fibrovascular membrane lying on the posterior surface of the vertebral bodies and attaching to the deep layer of the posterior longitudinal ligament: an anatomical, radiologic and clinical study. Spine. 1993;18:1030–43.

    Article  CAS  Google Scholar 

  18. Plaisant O, Sarrazin JL, Cosnard G, et al. The lumbar anterior epidural cavity: the posterior longitudinal ligament, the anterior ligaments of the dura mater and the anterior internal vertebral plexus. Acta Anat. 1996;155:274–81.

    Article  CAS  Google Scholar 

  19. De Andrès J, Reina MA, Macès F, et al. Epidural fat: considerations for minimally invasive spinal injection and surgical therapies. JNR. 2011;1:45–53.

    Google Scholar 

  20. Reina MA, Villanueva MC, Machès Fet al. The ultrastructure of the human spinal nerve root cuff in the lumbar spine. Anesth Analg. 2008;106:339–44.

    Article  Google Scholar 

  21. Gerhater R, St Louis EL. Lumbar epidural venography: review of 1200 case. Neuroradiology. 1979;131:409–21.

    Google Scholar 

  22. Reina MA, Dittmann M, López A, et al. New perspectives in the microscopic structure of human dura mater in the dorso lumbar region. Reg Anesth. 2001;22:161–6.

    Google Scholar 

  23. Reina MA, Prats-Galino A, Sola RG, et al. Structure of the arachnoid layer of the human spinal meninges: a barrier that regulates dural sac permeability. Rev Esp Anestesiol Reanim. 2010;57:486–92.

    Article  CAS  Google Scholar 

  24. Reina MA, De Leon Casasola O, Lòpez A, et al. The origin of the spinal subdural space: ultrastructure findings. Anesth Analg. 2002;94:991–5.

    Article  Google Scholar 

  25. Collier CB, Reina MA, Prats-Galino A, et al. An anatomical study of the intradural space. Anaesth Intensive Care. 2011;39:1038–42.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. European School of Obstetric Anesthesia, Rome, Italy

    Giorgio Capogna

Authors
  1. Giorgio Capogna
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Capogna, G. (2020). Anatomy of the Lumbar Epidural Region. In: Epidural Technique In Obstetric Anesthesia. Springer, Cham. https://doi.org/10.1007/978-3-030-45332-9_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-45332-9_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-45331-2

  • Online ISBN: 978-3-030-45332-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation