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Imaging in spinal posterior epidural space lesions: A pictorial essay

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ABSTRACT

Spinal epidural space is a real anatomic space located outside the dura mater and within the spinal canal extending from foramen magnum to sacrum. Important contents of this space are epidural fat, spinal nerves, epidural veins and arteries. Due to close proximity of posterior epidural space to spinal cord and spinal nerves, the lesions present with symptoms of radiculopathy and/or myelopathy. In this pictorial essay, detailed anatomy of the posterior epidural space, pathologies affecting it along with imaging pearls to accurately diagnose them are discussed. Various pathologies affecting the posterior epidural space either arising from the space itself or occurring secondary to vertebral/intervertebral disc pathologies. Primary spinal bone tumors affecting the posterior epidural space have been excluded. The etiological spectrum affecting the posterior epidural space ranges from degenerative, infective, neoplastic - benign or malignant to miscellaneous pathologies. MRI is the modality of choice in evaluation of these lesions with CT scan mainly helpful in detecting calcification. Due to its excellent soft tissue contrast, Magnetic Resonance Imaging is extremely useful in assessing the pathologies of posterior epidural space, to know their entire extent, characterize them and along with clinical history and laboratory data, arrive at a specific diagnosis and guide the referring clinician. It is important to diagnose these lesions early so as to prevent permanent neurological complication.

No MeSH data available.


Anatomy of epidural space: Sagittal (A) and axial T1-weighted (B) images of lumbar spine showing anterior boundary of the epidural space formed by posterior longitudinal ligament, posterior margin of vertebral bodies (arrow), and intervertebral discs (white arrowhead). Note the triangular shape of posterior epidural space in lumbar spine (elbow arrow). Pedicles and intervertebral foraminae (black arrowhead) form the lateral boundaries
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Figure 2: Anatomy of epidural space: Sagittal (A) and axial T1-weighted (B) images of lumbar spine showing anterior boundary of the epidural space formed by posterior longitudinal ligament, posterior margin of vertebral bodies (arrow), and intervertebral discs (white arrowhead). Note the triangular shape of posterior epidural space in lumbar spine (elbow arrow). Pedicles and intervertebral foraminae (black arrowhead) form the lateral boundaries

Mentions: Spinal epidural space extends rostrally from the fusion of spinal and periosteal layers of dura mater at foramen magnum[2] up to the sacrocoocygeal membrane caudally. The fusion of the former prevents intracranial extension. The space is limited ventrally by the posterior longitudinal ligament, posterior margins of vertebral bodies and intervertebral discs. The posterior margin is formed by ligamentum flavum, capsule of facet joints and laminae. Pedicles and intervertebral foraminae form the lateral boundaries [Figures 1 and 2].


Imaging in spinal posterior epidural space lesions: A pictorial essay
Anatomy of epidural space: Sagittal (A) and axial T1-weighted (B) images of lumbar spine showing anterior boundary of the epidural space formed by posterior longitudinal ligament, posterior margin of vertebral bodies (arrow), and intervertebral discs (white arrowhead). Note the triangular shape of posterior epidural space in lumbar spine (elbow arrow). Pedicles and intervertebral foraminae (black arrowhead) form the lateral boundaries
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036327&req=5

Figure 2: Anatomy of epidural space: Sagittal (A) and axial T1-weighted (B) images of lumbar spine showing anterior boundary of the epidural space formed by posterior longitudinal ligament, posterior margin of vertebral bodies (arrow), and intervertebral discs (white arrowhead). Note the triangular shape of posterior epidural space in lumbar spine (elbow arrow). Pedicles and intervertebral foraminae (black arrowhead) form the lateral boundaries
Mentions: Spinal epidural space extends rostrally from the fusion of spinal and periosteal layers of dura mater at foramen magnum[2] up to the sacrocoocygeal membrane caudally. The fusion of the former prevents intracranial extension. The space is limited ventrally by the posterior longitudinal ligament, posterior margins of vertebral bodies and intervertebral discs. The posterior margin is formed by ligamentum flavum, capsule of facet joints and laminae. Pedicles and intervertebral foraminae form the lateral boundaries [Figures 1 and 2].

View Article: PubMed Central - PubMed

ABSTRACT

Spinal epidural space is a real anatomic space located outside the dura mater and within the spinal canal extending from foramen magnum to sacrum. Important contents of this space are epidural fat, spinal nerves, epidural veins and arteries. Due to close proximity of posterior epidural space to spinal cord and spinal nerves, the lesions present with symptoms of radiculopathy and/or myelopathy. In this pictorial essay, detailed anatomy of the posterior epidural space, pathologies affecting it along with imaging pearls to accurately diagnose them are discussed. Various pathologies affecting the posterior epidural space either arising from the space itself or occurring secondary to vertebral/intervertebral disc pathologies. Primary spinal bone tumors affecting the posterior epidural space have been excluded. The etiological spectrum affecting the posterior epidural space ranges from degenerative, infective, neoplastic - benign or malignant to miscellaneous pathologies. MRI is the modality of choice in evaluation of these lesions with CT scan mainly helpful in detecting calcification. Due to its excellent soft tissue contrast, Magnetic Resonance Imaging is extremely useful in assessing the pathologies of posterior epidural space, to know their entire extent, characterize them and along with clinical history and laboratory data, arrive at a specific diagnosis and guide the referring clinician. It is important to diagnose these lesions early so as to prevent permanent neurological complication.

No MeSH data available.