Fluoroscopic Assessment Of Epidural Contrast Spread After Caudal Injection

Efficacy of therapeutic fluoroscopy-guided lumbar spine interventional procedures

PURPOSE

To evaluate the benefit of fluoroscopy-guided lumbar spine interventional procedures in treatment of low back pain.

METHODS

This prospective descriptive study was performed on 60 patients with back/radicular pain after showing no improvement with conservative treatment.

RESULTS

One hundred and two injection sessions were done (average 1.7 injection per patient). Caudal and lumbar transforaminal injections were effective in 55.9% and 78.5%, respectively. Facet and sacroiliac interventions were effective in 28.3% and 10%, respectively. Complications occurred in 20% of the procedures.

CONCLUSION

Lumbar injections improved pain/disability related to discogenic lumbar spinal diseases. Efficacy of facet and sacroiliac injections is limited.

Epidural steroid injections

Epidural steroid injections have a significant role in the treatment of patients with low back, neck, and radicular pain. Although these procedures may not address the causative lesions, they often shorten the clinical course of the disease process, keep patients out of the hospital, and provide symptomatic relief that improves quality of life. These procedures are most accurately performed with fluoroscopic guidance and major complications are rare. Although support for cervical epidural steroid injection is less uniform than that for lumbar and caudal injections, a growing body of experience is beginning to support its efficacy and safety.