PubMed · 2136155
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1990. Intradural spinal surgery.. https://pubmed.ncbi.nlm.nih.gov/2136155/
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We prospectively examined the distance from the skin to the epidural space (SE distance) in 95 Japanese parturient women who underwent epidural anesthesia at the L1-2 interspace, and studied the correlation between various physical factors and SE distance. The same anesthesiologist inserted the epidural tubing with the patient in the right lateral decubitus position. An epidural needle was introduced into the skin vertically via the midline approach. The epidural space was located using the loss-of-resistance technique. SE distance was measured to the nearest 0.5 cm using centimeter markings on the shaft of the epidural needle. The median value of SE distance was 3.5 cm, with a range of 2.5 to 6.5 cm, and in 80% of cases SE distances were 3 to 4 cm. The correlation of body weight with SE distance was the highest of the physical factors (r2 = 0.800, p = 0.0001), and a simple regression equation was formulated to aid in predicting SE distance: "SE distance (cm) = 0.05 x body weight (kg) + 0.36". This formula will be a useful clinical guide for administering epidural anesthesia in Japanese parturient women. In conclusion, the SE distance in most Japanese parturient women is between 3 and 4 cm at the L1-2 interspace and this value is most closely correlated with their body weight.
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A 54-year-old black male with a 15-year history progressive lower extremity weakness was evaluated with a thoracic MRI that revealed epidural lipomatosis extending from T1-T10 with an associated syrinx at T1-3. He was neither overweight nor taking steroids. A multilevel thoracic laminectomy with resection of lipoma was performed without directly addressing the syrinx. Postoperatively, his symptoms improved and an MRI obtained 1 year after surgery demonstrated resolution of the syrinx. This is the only case of epidural lipomatosis with an associated syrinx that we have seen reported in the world literature.