Open AccessA Radiographic Measurement of the Anterior Epidural Space at L 4–5 Disc Level
Author(s) -
Xu Ruisheng,
Wu Jieshi,
Lu Haidan,
Zhu Haogang,
Li Xia,
Dong Jian,
Yuan Fenglai
Publication year - 2017
Publication title -
orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 23
eISSN - 1757-7861
pISSN - 1757-7853
DOI - 10.1111/os.12325
Subject(s) - epidural space , medicine , fluoroscopy , lumbar , radiography , anatomy , diskectomy , percutaneous , nuclear medicine , lumbar vertebrae , surgery
To observe the morphology character of the anterior epidural space at the L 4–5 disc level and to provide an anatomical basis for safely and accurately performing a percutaneous endoscopic lumbar discectomy ( PELD ). Fifty‐five cases with L 5 S 1 lumbar disc herniation were included in this study, and cases with L 4–5 disease were excluded. When the puncture needle reached the epidural space at the L 5 S 1 level, iohexol was injected at the pressure of 50 cm H 2 O during the PELD , then C‐Arm fluoroscopy was used to obtain standard lumbar frontal and lateral images. The widths of epidural space at the level of the L 4 lower endplate, the L 5 upper endplate, as well as the middle point of the L 4–5 disc were measured from the lumbar lateral X‐ray film. Epidural space at the L 4–5 disc plane performs like a trapezium chart with a short side at the head end and a long side at the tail end in the lumbar lateral X‐ray radiograph, while the average widths of epidural space were 10.2 ± 2.5, 12.3 ± 2.3, and 13.8 ± 2.6 mm at the upper, middle, and lower level of the L 4–5 disc. Understanding the morphological characteristics of epidural space will contribute to improving the safety of the tranforaminal percutaneous endoscopy technique.