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KMID : 0948920150140020080
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Clinical Pain
2015 Volume.14 No. 2 p.80 ~ p.86
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The Effect of Caudal Epidural Injection according to Needle Placement for Patients with Lumbosacral Radiculopathy or Spinal Stenosis
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Lee Hong-Jae
Lim Kil-Byung
Yoo Jee-Hyun
Yoon Sung-Won
Yun Hyun-Ju
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Abstract
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Objective: To evaluate the effect of caudal epidural injection according to needle placement and needle types.
Method: Subjects with lumbosacral radiculopathy or spinal stenosis confirmed by the imaging studies were enrolled. In the Tuohy group, we used conventional method with Tuohy epidural needle (20 G, 80 mm length) with advancing it upwardly followed by injecting the steroid solution 20 ml. Whereas in the 22 G needle group, we used a regular needle (22 G, 32 mm length) without advancing it. The primary measure was the spreading level of solution. In addition, visual analogue scale (VAS), Oswestry Disability Index (ODI), and the complications of the procedure were measured.
Results: Twenty three participants completed the study; 11 in Tuohy group and 12 in 22 G needle group. In Tuohy group, the ascending levels of injected solution were L3 in 2 cases, L4 in 5 cases, L5 in 3 cases, and S1 in 1 case. In the 22G needle group, those were L3 in 2 cases, L4 in 5 cases, and L5 in 5 cases. There were 1 case of blood regurgitation in the Tuohy group while 1 case of malposition of needle (stuck in sacrum). There were significant improvement in the VAS and ODI scores after the injections in each groups, but no significant differences between two groups.
Conclusion: The ascending level of the solution and pain reduction seemed to be similar in the both groups. Also, we found there was no vessel injury in the 22 G needle group.
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KEYWORD
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Low back pain, Caudal epidural injection, Needles, Fluoroscopy
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