Epiduralrummet

Epiduralrummet, also known as the epidural space, is the potential space between the dura mater and the periosteum lining the vertebral canal. In the spinal canal, it is a real space that contains adipose tissue, loose connective tissue, the internal vertebral venous plexus, lymphatics, and the dorsal and ventral nerve roots as they converge within the dural sac. The space extends from the foramen magnum to the sacral hiatus and is bounded anteriorly by the posterior longitudinal ligament and vertebral bodies, posteriorly by the ligamentum flavum and the vertebral arches, and laterally by the intervertebral foramina.

The epidural space is clinically important as the route for epidural anesthesia and analgesia. Injecting local anesthetic into the epidural space blocks nerve roots as they exit the dural sac, providing regional anesthesia for surgery or pain relief, such as labor analgesia. The space is also used for epidural steroid injections to treat radicular pain.

Access to the epidural space is typically gained via interlaminar, transforaminal, or caudal approaches; imaging guidance is often used to improve accuracy and safety. Potential complications include dural puncture with post-dural puncture headache, infection, hematoma, nerve injury, and unintended high spinal anesthesia.

The epidural space around the brain is a similar concept, referring to a potential space between the skull and dura that can become real after hemorrhage. Overall, the epidural space is distinct from the subdural and subarachnoid spaces and plays a key role in regional anesthesia and certain pain-management procedures.