title: Distance to the adult cervical epidural space.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Pain Clinic, Department of Anesthesiology, Ajou University Hospital, Suwon, Korea.
authors.forename: Kyung-Ream
authors.initials: KR
authors.lastname: Han
authors.forename: Chan
authors.initials: C
authors.lastname: Kim
authors.forename: Soo-Kyung
authors.initials: SK
authors.lastname: Park
authors.forename: Jin-Soo
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000375:Aging; D015992:Body Mass Index; D001835:Body Weight; D004824:Epidural Space / Q000033:anatomy & histology*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D016014:Linear Models; D008297:Male; D009333:Neck / Q000033:anatomy & histology; D009407:Nerve Block; D010146:Pain / Q000188:drug therapy; D012016:Reference Values