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Related Experiment Video

Updated: Aug 25, 2025

Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
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Dura-to-Spinal Cord Distance at Different Vertebral Levels in Indian Children: A Retrospective Computerized

Heena Garg1, Shailendra Kumar1, Naren Hemachandran2

  • 1Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.

Anesthesia, Essays and Researches
|October 17, 2022
PubMed
Summary

This study measured the dura-to-cord distance in Asian children to determine safe epidural insertion levels. The T8-9 interspace offers the greatest safety margin for pediatric epidural procedures.

Keywords:
Computerized tomography scanepiduralpediatricspinal cordthoracic

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Area of Science:

  • Pediatric Anesthesiology
  • Radiology
  • Spinal Anatomy

Background:

  • Neuraxial techniques are vital for pediatric postoperative analgesia.
  • Spinal cord injury from procedures can have severe consequences.
  • Identifying safe epidural insertion sites is crucial in children.

Purpose of the Study:

  • To evaluate dura-to-cord (DTC) distance in Asian children (1-16 years) using CT scans.
  • To identify safe thoracic interspaces for epidural catheter placement.
  • To analyze DTC variations based on age, gender, and spinal level.

Main Methods:

  • Retrospective analysis of 141 children's thoracolumbar CT scans.
  • Exclusion of patients with spinal abnormalities.
  • Measurement of DTC at T8-9, T9-10, and L1-2 interspaces.

Main Results:

  • Mean DTC distances were 3.51mm (T8-9), 2.73mm (T9-10), and 2.83mm (L1-2).
  • Significant gender differences in DTC noted at T9-10 and L1-2.
  • DTC at T8-9 correlated significantly with age, weight, and height.

Conclusions:

  • The thoracic epidural space is suitable for catheter placement in children.
  • The T8-9 interspace provides the maximum DTC, indicating a safer epidural insertion point.
  • CT-based DTC measurements are valuable for guiding pediatric epidural procedures.