TY - JOUR
T1 - The feasibility of color Doppler ultrasonography for caudal epidural steroid injection
AU - Yoon, Joon Shik
AU - Kyu, Hun Sim
AU - Sei, Joo Kim
AU - Woo, Sub Kim
AU - Seong, Beom Koh
AU - Kim, Byung Jo
PY - 2005/11
Y1 - 2005/11
N2 - Although it entails a radiation hazard risk, the use of fluoroscopy during caudal epidural steroid injection has increased to help place the medication more accurately and allowed physicians to maximize the procedure's therapeutic success rate. To investigate the feasibility of using real-time high resolution ultrasonography for guiding the epidural needle into the caudal epidural space and to confirm any vascular intake of medication, we performed color Doppler ultrasonography while medication was being injected into the caudal epidural space of 53 patients with low back pain and sciatica. We defined the injection as being successful if unidirectional flow (observed as one dominant color) of the solution was observed with color Doppler ultrasonography through the epidural space beneath the sacrococcygeal ligament, with no flows being observed in other directions (observed as multiple colors). The correct placement of the medication was then confirmed by fluoroscopy. In 52 of the 53 subjects, the medications were successfully injected into the caudal epidural space with ultrasonography assistance. In fluoroscopy, of these 52 patients, 50 revealed correct placement of the medicine into the epidural space. In conclusion, ultrasonography may be a reliable imaging modality for caudal epidural steroid injection, and its several advantages such as its convenience and the lack of a radiation hazard, make it preferable to fluoroscopy.
AB - Although it entails a radiation hazard risk, the use of fluoroscopy during caudal epidural steroid injection has increased to help place the medication more accurately and allowed physicians to maximize the procedure's therapeutic success rate. To investigate the feasibility of using real-time high resolution ultrasonography for guiding the epidural needle into the caudal epidural space and to confirm any vascular intake of medication, we performed color Doppler ultrasonography while medication was being injected into the caudal epidural space of 53 patients with low back pain and sciatica. We defined the injection as being successful if unidirectional flow (observed as one dominant color) of the solution was observed with color Doppler ultrasonography through the epidural space beneath the sacrococcygeal ligament, with no flows being observed in other directions (observed as multiple colors). The correct placement of the medication was then confirmed by fluoroscopy. In 52 of the 53 subjects, the medications were successfully injected into the caudal epidural space with ultrasonography assistance. In fluoroscopy, of these 52 patients, 50 revealed correct placement of the medicine into the epidural space. In conclusion, ultrasonography may be a reliable imaging modality for caudal epidural steroid injection, and its several advantages such as its convenience and the lack of a radiation hazard, make it preferable to fluoroscopy.
KW - Caudal epidural injection
KW - Fluoroscopy
KW - Ultrasonography
UR - http://www.scopus.com/inward/record.url?scp=27644534582&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=27644534582&partnerID=8YFLogxK
U2 - 10.1016/j.pain.2005.08.014
DO - 10.1016/j.pain.2005.08.014
M3 - Article
C2 - 16213088
AN - SCOPUS:27644534582
VL - 118
SP - 210
EP - 214
JO - Pain
JF - Pain
SN - 0304-3959
IS - 1-2
ER -