title: Feasibility and safety of ultrasound-guided caudal epidural glucocorticoid injections.
abstract: OBJECTIVE
  To assess the feasibility and safety of caudal epidural glucocorticoid injections performed with ultrasound guidance.
  
  
  METHODS
  We studied 30 patients with low back pain and nerve root pain related to disk herniation or associated with lumbar spinal stenosis. A caudal epidural injection was performed under ultrasound guidance. Prednisolone acetate, 5 ml, was administered with 10 ml of saline and 5 ml of iodinated contrast agent, providing an epidurogram. Acceptability of the procedure by the patient was assessed. Adverse events occurring immediately after the procedure and within the first month were collected.
  
  
  RESULTS
  The sacral hiatus was identified in 29 (96.6%) patients. Mean distance between the two sacral cornua was 1.42 cm (range, 0.83-2.13) and mean diameter of the sacral hiatus was 0.60 cm (0,2-1.28). The injection proved feasible in 28 of the 29 patients. The epidurogram indicated that the injection was successful in 27 patients. Mean procedure duration was 15 minutes (30-10). No cerebrospinal fluid reflux occurred. Blood reflux was noted in 9/29 patients and resolved in eight upon needle repositioning. All patients deemed the procedure acceptable. No complications were recorded during the first month.
  
  
  CONCLUSIONS
  Ultrasound-guided caudal glucocorticoid injection is a fast, easy-to-perform, well accepted procedure. In our study, an epidurogram confirming that the needle was in the epidural space was obtained in 27 of 28 patients.
authors.affiliation: Service de rhumatologie, Hôtel-Dieu, CHU de Nantes, Nantes cedex 1, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Blanchais
authors.forename: Benoit
authors.initials: B
authors.lastname: Le Goff
authors.forename: Pascale
authors.initials: P
authors.lastname: Guillot
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Berthelot
authors.forename: Joëlle
authors.initials: J
authors.lastname: Glemarec
authors.forename: Yves
authors.initials: Y
authors.lastname: Maugars
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007268:Injections, Epidural / Q000379:methods*; D017116:Low Back Pain / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018084:Ultrasonography, Interventional; D055815:Young Adult
chemical_list: C009935:prednisolone acetate; D011239:Prednisolone