• Pain Pract · Sep 2005

    Accuracy of caudal epidural injection: the importance of real-time imaging.

    • Atilla Ergin, Omer Yanarates, Ali Sizlan, M Emin Orhan, Ercan Kurt, and M Erdal Guzeldemir.
    • Gulhane Military Medical Faculty, Department of Anaesthesiology and Reanimation, Ankara, Turkey. aergin@gata.edu.tr.
    • Pain Pract. 2005 Sep 1; 5 (3): 251-4.

    AbstractCaudal epidural steroid injections are often used for low back pain. Fluoroscopic guidance has been frequently cited as a requirement for this procedure. In this preliminary report, we demonstrate that fluoroscopic guidance for caudal epidural Tuohy needle placement without real-time imaging may result in inadvertent intravenous injection of the drug. We detected intravenous leakage of the drug in 4 cases of 10 when real-time fluoroscopic imaging was used. Thus, real-time imaging may be recommended in addition to routine fluoroscopic guidance for caudal epidural procedures, as it may improve efficacy and safety by assuring accurate drug deposition.

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