title: Accuracy of caudal epidural injection: the importance of real-time imaging.
abstract: Caudal epidural steroid injections are often used for low back pain. Fluoroscopic guidance has been frequently cited as a requirement for this procedure. In this preliminary report, we demonstrate that fluoroscopic guidance for caudal epidural Tuohy needle placement without real-time imaging may result in inadvertent intravenous injection of the drug. We detected intravenous leakage of the drug in 4 cases of 10 when real-time fluoroscopic imaging was used. Thus, real-time imaging may be recommended in addition to routine fluoroscopic guidance for caudal epidural procedures, as it may improve efficacy and safety by assuring accurate drug deposition.
authors.affiliation: Gulhane Military Medical Faculty, Department of Anaesthesiology and Reanimation, Ankara, Turkey. aergin@gata.edu.tr.
authors.forename: Atilla
authors.initials: A
authors.lastname: Ergin
authors.forename: Omer
authors.initials: O
authors.lastname: Yanarates
authors.forename: Ali
authors.initials: A
authors.lastname: Sizlan
authors.forename: M Emin
authors.initials: ME
authors.lastname: Orhan
authors.forename: Ercan
authors.initials: E
authors.lastname: Kurt
authors.forename: M Erdal
authors.initials: ME
authors.lastname: Guzeldemir