| Epidural space | |
| Latin: | spatium epidurale, spatium extradurale, cavum epidurale |
| Width: | 120 |
In anatomy, the epidural space is the potential space between the dura mater and vertebrae (spine).[1] [2]
The anatomy term "epidural space" has its origin in the Ancient Greek language;, "on, upon" + dura mater also known as "epidural cavity", "extradural space" or "peridural space". In humans the epidural space contains lymphatics, spinal nerve roots, loose connective tissue, adipose tissue, small arteries, dural venous sinuses and a network of internal vertebral venous plexuses.[3]
In the skull, the periosteal layer of the dura mater adheres to the inner surface of the skull bones while the meningeal layer lays over the arachnoid mater. Between them is the epidural space. The two layers of the dura mater separate at several places, with the meningeal layer projecting deeper into the brain parenchyma forming fibrous septa that compartmentalize the brain tissue. At these sites, the epidural space is wide enough to house the epidural venous sinuses.[4] [5]
There are four fibrous septa:
In pathological conditions fluid such as blood can fill this space. For example a torn meningeal artery (often the middle meningeal artery) or dural venous sinus (rarely) may bleed into this potential space and result in an epidural hematoma.
In the spinal canal, the periosteal layer adheres to the inner surface of the spinal canal which is formed by the bodies of vertebrae. The meningeal layer lays over the spinal arachnoid mater. Between the vertebrae and the dural sheath is the spinal epidural space. Unlike the cranial epidural space, the spinal epidural space contains adipose tissue, the internal vertebral venous plexuses and the spinal nerve roots. The spinal epidural space spans the length of the spinal cord, from the foramen magnum superiorly to the sacral hiatus inferiorly.[6]
Epidural space is the smallest at the cervical region, measuring 1 to 2 mm. At L2 to L3, enlarges until 5 to 6 mm. It then enlarges progressively until lower lumbar and sacral region.[7] However, some authors stated that it decreases in size after mid-lumbar region until 2 mm at S1 level.[8]