spinal stenosis
Caudal Epidural Steroid injection procedures are performed to relieve low back and radiating leg pain. The steroid medication can reduce the swelling and inflammation caused by spinal conditions such as spinal stenosis, radiculopathy, sciatica, and herniated discs.
In this procedure the patient lies face down on the table and a cushion is placed underneath the stomach area for comfort and to arch the back. The pain physician then uses a fluoroscope (x-ray machine) to find the small opening at the base of the sacrum called the sacral hiatus.
A local anesthetic is then used to numb the skin and all of the soft tissues down to the surface of the sacral hiatus. The pain physician then guides a needle through that anesthetized track and into the epidural space. The needle is carefully inserted about 1 to 2 cm.
Once inside the sacral hiatus space a contrast or nonallergenic iodine base solution is injected. This solution helps the pain physician to see the diseased and painful areas using the fluoroscope. A steroid and anesthetics mix is injected into the epidural space bathing the painful area and medication. The needle is removed.
The tiny surface wounds is covered with a small band aid. In some cases it may be necessary to repeat the procedure as many as three times for the patient to feel the full benefit of the medication. However, many patients feel significant relief from only one or two injections.
If a patient has a disease process at numerous spinal levels, a caudal injection may help significantly. The reason is it can bathe numerous levels with the steroid medication giving the patient the best chance of pain relief success with a multi-level problem.
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