Distance to the adult cervical epidural space

Abstract

Background and Objectives: Cervical epidural block is useful in the management of a variety of acute, chronic, and cancer-related pain syndromes involving the head, face, neck, and upper extremities. Knowledge of the depth from the skin to the cervical epidural space (DSES) may be helpful when performing cervical epidural block and may reduce the possibility of complications. We studied DSES in adults and its relationship with patient age, height, weight, and neck circumference. Methods: The study included 816 patients. Cervical epidural block was performed at the C5-6, C6-7, and C7-T1 intervertebral space by a midline approach under fluoroscopic guidance. The depth to the epidural space from the skin was measured. Results: DSES at C5-6, C6-7, and C7-T1 was 4.7 ± 0.6 cm, 5.1 ± 0.6 cm, 5.6 ± 0.8 cm in males and 4.0 ± 0.6 cm, 4.6 ± 0.6 cm, 5.0 ± 0.6 cm in females (mean ± SD). Linear regression analysis revealed significant correlations between DSES and weight, neck circumference, and body mass index. Conclusion: DSES varies with cervical intervertebral space. DSES increases as one moves caudally. The greatest DSES was noted at C7-T1 in men, and the least was at C5-6 in women. DSES had a significant relationship with weight, neck circumference, and body mass index in both genders. Reg Anesth Pain Med 2003;28:95-97.