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Practically, this means the following: If an anaesthetist performs an epidural block low down in the back, at the so-called lumbar level, the nerves that innervate the lower abdomen and the legs are going to be affected. This is suitable for e.g. surgery on the prostate, hysterectomies, hip and knee surgery.

If the epidural injection is done higher up in the back (lower thoracic level) the nerves leaving and entering the spinal cord at a higher level will be blocked, i.e. innervating the upper and lower abdomen, but not the legs. This is suitable for surgery on the upper abdomen (stomach, bowel, liver, etc).

For surgery on the chest, even higher placed epidurals are necessary (between the shoulder blades, higher thoracic level). This will block the innervation of the chest and upper abdomen, but not the lower abdomen or the legs.

Read more:
Breast lumps & breast pain
Managing back pain

Links:
Arthritis Foundation of South Africa
Multiple Sclerosis South Africa
The South African Society of Physiotherapy

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