A RAPID-TRANSPORT ROUTE BETWEEN THE EPIDURAL SPACE AND THE INTRANEURAL CAPILLARIES OF THE NERVE ROOTS

Study Design. The possibility of epidurally applied substances reaching the intraneural capillaries of the spinal nerve roots and cauda equina was assessed in the pig sacrococcygeal spine. Methods. The presence of Evans blue-labelled albumin in intraneural capillaries after epidural application for 1, 10, or 30 minutes was studied with fluorescence microscopy. Ink angiography was used to determine whether there were any direct communicating vessels between the epidural vein plexus and the intraneural capillaries. Results. Evans blue-labelled albumin was present in the intraneural capillaries 1 minute after epidural application. Microangiography demonstrated small venules that connected the epidural vein plexus and the intra-neural capillaries. Conclusions. The results of this study demonstrated a rapid transport route between the epidural space and the intraneural capillaries. The results suggest that the nucleus pulposus material, as well as epidurally applied substances, such as local anesthetic drugs or epidurally injected corticosteriods, may have a rapid, direct transport route to the axons of the spinal nerve roots. The demonstrated transport route also may be related to the mechanisms behind epidural anesthesia and spinal nerve root infiltration.