title: Ultrasound-Guided Versus Fluoroscopy-Guided Caudal Epidural Steroid Injection for the Treatment of Unilateral Lower Lumbar Radicular Pain: Case-Controlled, Retrospective, Comparative Study.
abstract: The aim of the article is to investigate the efficacy of ultrasound (US)-guided Caudal Epidural Steroid Injection (CESI) compared with fluoroscopy (FL)-guided CESI in patients with unilateral lower lumbar radicular pain. This case-controlled, retrospective, comparative study was done at the university hospital. A total of 110 patients treated with US- or FL-guided CESI were administered a mixture of 20 cc (0.5% lidocaine 18.0  mL + dexamethason 10  mg 2  mL). Outcome measurement was assessed by Oswestry Disability Index (ODI), verbal numeric pain scale (VNS) before injections and at 3, 6, and 12 months after the last injections. Successful outcome was defined as measured by >50% improvement in the VNS score and >40% improvement in the ODI. ODI and VNS showed improvement at 3, 6, and 12 months after the last injection in both groups. No statistical differences in ODI, VNS were observed between groups (P < 0.05). No significant differences in the proportion of patients with successful treatment were observed between the groups from the 3-month to 6-month to 12-month outcomes. US-guided CESI is deserving of consideration in conservative management of unilateral lower lumbar radicular pain.
authors.affiliation: From the Department of Rehabilitation Medicine, Gachon University, Gil Medical Center, Incheon, Korea (KDP); Department of Rehabilitation Medicine, Hanyang University College of Medicine, Seoul, South Korea (TKK); Department of Anesthesiology, Sanggye Paik Hospital, Inje University College of Medicine (WYL); and Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea (JA, SHK, YP).
authors.forename: Ki Deok
authors.initials: KD
authors.lastname: Park
authors.forename: Tai Kon
authors.initials: TK
authors.lastname: Kim
authors.forename: Woo Yong
authors.initials: WY
authors.lastname: Lee
authors.forename: JaeKi
authors.initials: J
authors.lastname: Ahn
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Koh
authors.forename: Yongbum
authors.initials: Y
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D005471:Fluoroscopy; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007268:Injections, Epidural; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D011843:Radiculopathy / Q000150:complications* / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone