The spinal epidural and posterior ligamentous complex spaces are important anatomic regions which are the target of various radiologic procedures in the cervical, thoracic and lumbar spine for the purpose of analgesia and anaesthesia. Given the frequency with which procedures are performed in and around the epidural space, a sound understanding of the associated anatomy is paramount to ensure the safety and efficacy of procedural intervention.
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http://dx.doi.org/10.1111/1754-9485.13076 | DOI Listing |
Anaesth Rep
October 2024
Department of Anaesthesiology, Pain and Healing Center MetroHealth Medical Center Cleveland OH USA.
Pain Physician
May 2024
Department of Anesthesiology and Pain Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea.
Background: Transforaminal epidural steroid injection (TFESI) is commonly used for radicular pain, but can lead to an unintentional injection into the retrodural Space of Okada (RSO), an extradural space located dorsal to the ligamentum flavum, instead of the epidural space.
Objectives: To determine the prevalence and describe the fluoroscopic imaging features of an unintentional injection into the RSO during a TFESI and to review the history of injections into the RSO.
Study Design: Observational study and original research.
Interv Neuroradiol
January 2024
Division of Musculoskeletal Radiology, Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Epidural steroid injections are commonly performed using fluoroscopic or CT guidance. With both modalities, the injection of contrast material is necessary before steroid administration to ensure adequate epidural flow and exclude non-epidural flow. While fluoroscopic guidance is conventional, CT is utilized at some centers and can be particularly helpful in the setting of challenging or postoperative anatomy.
View Article and Find Full Text PDFReg Anesth Pain Med
January 2023
Translational Research Unit for Anatomy and Analgesia, Yonsei University College of Medicine, Seoul, Korea
Background: The retrodural space of Okada is a potential space posterior to the ligamentum flavum that allows communication with the bilateral facet joints. However, the actual anatomy of this space has not been clearly visualized to date. We sought to investigate the characteristics of patients showing contrast spreading to the facet joint space during epidural injection and to clarify the anatomical structures of the retrodural space and adjacent ligamentous tissues in cadaveric specimens.
View Article and Find Full Text PDFPain Med
July 2022
Department of Physical Medicine & Rehabilitation, University of Utah Health, Salt Lake City, Utah, USA.
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