Annals of Rehabilitation Medicine

Original Article: J Korean Acad Rehabil Med. 2005;29(5):483-488.; Confirming of Needle Position and Spreading of Solution according to Injection Volume in Caudal Epidural Injection.; Kang, Si Hyun , Seo, Kyung Mook , Kim, Don Kyu , Shin, Ju Yon; Department of Rehabilitation Medicine, College of Medicine, Chungang University, Korea. kmseo@cau.ac.kr

Abstract: Objective
To know the accuracy of caudal epidural steroid injection procedure without fluoroscopy guidance, and determine ascending level of injected solution according to injection volume. Method: The subjects were 35 patients with low back pain. Needle insertion was performed without fluoroscopy, then we confirm the position of needle with fluoroscopy. The level of injected solution was measured with fluoroscopy and x-ray after injecting every 5 ml of solution, which is mixture of triamcinolone, 2% lidocaine, contrast medium, and normal saline. The effect of treatment was measured by Visual Analogue Scale (VAS).Results: Successful needle placement occurred in 27 cases without fluoroscopy. After injecting 20 ml of solution, the ascending level of solution were S1 in 8 cases, L5 in 12 cases, L4 in 8 cases, L3 in 1 case, L2 in 4 cases, L1 in 2 cases. In the comparison of the VAS before and after treatment, it was 6.3⁑1.2 and 2.9⁑1.3 respectively, which demonstrated statistically significant decrease (p＜0.05). Conclusion: Caudal epidural injection could be performed more accurately under the fluoroscopic guidance. After injecting 20 ml of solution, the ascending level of the solution were restricted at lower lumbosacral area in most of cases. (J Korean Acad Rehab Med 2005; 29: 483-488)

Keywords :Caudal epidural injection, Fluoroscopy, Injection volume, Low back pain