scholarly journals Determination of the Optimal Angle for Needle Insertion During Caudal Epidural Steroid Injection in Adults Using Ultrasound Imaging

2018 ◽  
Vol 20 (8) ◽  
Author(s):  
Erhan Gökçek ◽  
Ayhan Kaydu
Keyword(s):  
Ultrasound Imaging ◽  
Steroid Injection ◽  
Needle Insertion ◽  
Epidural Steroid Injection ◽  
Optimal Angle ◽  
Epidural Steroid ◽  
Caudal Epidural

Caudal Epidural Steroid Injection: Ultrasound

2016 ◽  
Author(s):  
Imanuel R. Lerman
Keyword(s):  
Ultrasound Guidance ◽  
Steroid Injection ◽  
Imaging Technique ◽  
Imaging Modality ◽  
Needle Insertion ◽  
Epidural Steroid Injection ◽  
Fluoroscopic Guidance ◽  
Sacral Hiatus ◽  
Epidural Steroid ◽  
Caudal Epidural

Ultrasound guidance can facilitate caudal epidural steroid injection by providing a clear view of the sacrum, the sacral hiatus, and the needle as it is advanced through the sacrococcygeal ligament into the sacral hiatus. Using ultrasound guidance for the initial needle insertion can eliminate the exposure of the physician and patient to ionizing radiation. However, the use of ultrasound guidance as a sole imaging technique for caudal epidural steroid injection does have disadvantages. Contrast fluoroscopic guidance is necessary to visualize the needle once it passes under the apex of the sacral hiatus to confirm that the needle tip is extradural and indeed extravascular. The use of ultrasound and fluoroscopic guidance takes advantage of each imaging modality to enhance the safety and accuracy of the caudal epidural steroid injection.

scholarly journals Caudal epidural steroid injection ultrasound-guided versus fluoroscopy-guided in treatment of refractory lumbar disc prolapse with radiculopathy

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Mohamed Ahmed Elashmawy ◽  
Reham M. Shaat ◽  
A. M. Abdelkhalek ◽  
Ebrahim El Boghdady
Keyword(s):  
Steroid Injection ◽  
Lumbar Disc ◽  
Epidural Steroid Injection ◽  
Successful Outcome ◽  
Post Injection ◽  
Disc Prolapse ◽  
Lumbar Disc Prolapse ◽  
Straight Leg Raising ◽  
Epidural Steroid ◽  
Caudal Epidural

Abstract Background Lumbar disc prolapse is a localized herniation of disc beyond intervertebral disc space and is the most common cause of sciatica; the aim of this study is to investigate the efficacy of ultrasound (US)-guided caudal epidural steroid injection (CESI) compared with fluoroscopy (FL)-guided CESI in treatment of patients with refractory lumbar disc prolapse (LDP) with radiculopathy. Results At the beginning of the study, there was no significant difference between both groups in all parameters. (a) Group 1 had significantly improved the straight leg raising and modified Schober tests, VAS, and ODI at 1-month and 3-month post-injection evaluation in comparison to baseline recordings (p < 0.001); (b) Group 2 had significantly improved the straight leg raising and modified Schober tests, VAS, and ODI at 1-month and 3-month post-injection evaluation in comparison to baseline recordings (p < 0.001); and (c) US-guided CESI was not statistically different from the FL-guided CESI in the improvement of the straight leg raising (p = 0.87, 0.82) and modified Schober tests (p = 0.87, 0.82) as well as VAS (p = 0.40, 0.43) and ODI (p = 0.7, 0.2) at 1-month and 3-month post-injection evaluation. In a multivariate analysis using CI = 95%, the significant predictors for a successful outcome were duration < 6 months (p = 0.03, OR = 2.25), target level not L2-3/L3-4 (p < 0.001, OR = 4.13), and LDP other than foraminal type (p = 0.002, OR = 3.78). However, age < 40 years was found to be non-significant in predicting a successful outcome (p = 0.38, OR = 0.98). Conclusion US is excellent in guiding CESI with similar treatment outcomes as compared with FL-guided CESI. Trial registration ClinicalTrials.gov Identifier: NCT03933150.

Comparison of Caudal Epidural Steroid Injection with Interlaminar Lumbar Inj. Epidural in Spinal Stenosis

2021 ◽  
Vol 15 (8) ◽  
pp. 1877-1879
Author(s):  
Muhammad Akram ◽  
Faheem Mubashir Farooqi ◽  
Shumaila Jabbar
Keyword(s):  
Spinal Stenosis ◽  
Oswestry Disability Index ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Group I ◽  
Group Ii ◽  
Epidural Steroid ◽  
Caudal Epidural

Background: Lumbar spinal stenosis is a condition caused by narrowing of spinal canal. Steroid injection either lumbar or caudal can improve the functional outcome and low back pain. Aim: To compare the outcome of caudal epidural steroid injection with lumbar epidural steroid injection in treating spinal stenosis in patients suffering from sciatica. Methods: In this prospective study 338 patients having low backache due to spinal stenosis with sciatica were included from June 2013 to December 2014. Patients were randomly divided into two groups. Group I and II. Patients in Group I (160 patients) received caudal epidural steroid injections while the patients in Group II (178 patients) received lumbar epidural steroid injections. Visual analog scale (VAS) and Oswestry Disability Index (ODI) was used to assess outcome of the Caudal and Lumbar steroid injections and was measured at 2 weeks, at 3months, and improvement was declared if VAS decrease ≥50% of baseline and Oswestry disability index decrease ≥40% at 3 months. Results: In group I, there were 70(43.75%) males and 90(56.25%) females, while in group II there were 98(55.1%) males and 80(44.9%) females. The mean age of the patients in group I was 46.46±10.37 (18-75 years) years and was 43.77±15.27 years (18-75 years) in group II (P=0.0619). The change in pain score (>50%) was observed in 159 (89.33%) in group II compared with 121 (75%) in group I (P=0.0008). Conclusion: Lumbar epidural of steroids injections are more effective then caudal epidural injection of steroids in treating spinal stenosis. MeSH words: Caudal epidural, Lumbar epidural, Sciatica

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