Ultrasound guidance in caudal epidural needle placement.
BACKGROUND
This study was conducted to investigate the feasibility of using ultrasound as an image tool to locate the sacral hiatus accurately for caudal epidural injections.


METHODS
Between August 2002 and July 2003, 70 patients (39 male and 31 female patients) with low back pain and sciatica were studied. Soft tissue ultrasonography was performed to locate the sacral hiatus. A 21-gauge caudal epidural needle was inserted and guided by ultrasound to the sacral hiatus and into the caudal epidural space. Proper needle placement was confirmed by fluoroscopy.


RESULTS
In all the recruited patients, the sacral hiatus was located accurately by ultrasound, and the caudal epidural needle was guided successfully to the sacral hiatus and into the caudal epidural space. There was 100% accuracy in caudal epidural needle placement into the caudal epidural space under ultrasound guidance as confirmed by contrast dye fluoroscopy.


CONCLUSIONS
Ultrasound is radiation free, is easy to use, and can provide real-time images in guiding the caudal epidural needle into the caudal epidural space. Ultrasound may therefore be used as an adjuvant tool in caudal needle placement.
Chen
Carl P C
CP
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taiwan. carlchendr@yahoo.com.tw
Tang
Simon F T
SF
Hsu
Tsz-Ching
TC
Tsai
Wen-Chung
WC
Liu
Hung-Pin
HP
Chen
Max J L
MJ
Date
Elaine
E
Lew
Henry L
HL
D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D004824:Epidural Space / Q000000981:diagnostic imaging*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy; D008297:Male; D009339:Needles; D012585:Sciatica / Q000188:drug therapy; D014463:Ultrasonography