Brown Ashlyn, Parmar Jason, Ganji-Angirekula Suma, Robinson Christopher L, Al-Jumah Rana, Gill Jatinder, Hasoon Jamal
H. Ben Taub Department of Physical Medicine and Rehabilitation Baylor College of Medicine.
Department of Emergency Medicine The University of Texas Health Science Center at Houston.
Orthop Rev (Pavia). 2024 Sep 14;16:123283. doi: 10.52965/001c.123283. eCollection 2024.
INTRODUCTION: Caudal epidural steroid injections (ESIs) are commonly employed in the management of low back pain and radiculopathy. Despite their widespread use, practice patterns among physicians performing caudal ESIs can vary significantly. This study aims to identify variability in injection techniques utilized by physicians during caudal ESIs, focusing on steroid use, needle selection, and catheter use. This study also looks at major permanent neurological injuries related to caudal ESIs. METHODS: A survey was distributed to a cohort of physicians who regularly perform ESIs. The survey comprised questions regarding the type of needle primarily used, steroid selection, the use of catheters, and major neurological injuries from caudal ESIs. The respondents included a diverse group of pain management physicians from various specialties and practice settings. RESULTS: The results revealed a predominant preference for the use of particulate steroids (72.41%) when performing caudal ESIs. Additionally, physicians primarily prefer to use spinal needles (72.41%) compared to other needle types. A majority of physicians (65.12%) reported that they never use a catheter when performing caudal ESIs to access higher pathology. Finally, all physician responders (100%) reported that they have never caused a permanent neurological injury when performing a caudal ESI. CONCLUSION: This survey provides initial data among physicians who perform caudal ESIs. Our results demonstrate the majority of physicians favor using particulate steroids and a spinal needle, with fewer opting to use a catheter during these procedures. There were no reported major permanent neurological injuries, demonstrating that caudal ESIs are a safe interventional option for managing lumbosacral pain complaints.
引言:骶管硬膜外类固醇注射(ESIs)常用于治疗腰痛和神经根病。尽管其广泛应用,但进行骶管ESIs的医生的操作模式可能存在显著差异。本研究旨在确定医生在骶管ESIs过程中使用的注射技术的变异性,重点关注类固醇的使用、针头选择和导管使用。本研究还探讨了与骶管ESIs相关的主要永久性神经损伤。 方法:向一组定期进行ESIs的医生发放了一份调查问卷。该调查包括有关主要使用的针头类型、类固醇选择、导管使用以及骶管ESIs导致的主要神经损伤的问题。受访者包括来自不同专业和执业环境的各种疼痛管理医生。 结果:结果显示,在进行骶管ESIs时,医生们主要倾向于使用颗粒状类固醇(72.41%)。此外,与其他类型的针头相比,医生们主要更喜欢使用脊椎针(72.41%)。大多数医生(65.12%)报告说,他们在进行骶管ESIs以处理更高部位的病变时从不使用导管。最后,所有参与调查的医生(100%)报告说,他们在进行骶管ESIs时从未造成永久性神经损伤。 结论:这项调查提供了进行骶管ESIs的医生的初步数据。我们的结果表明,大多数医生倾向于使用颗粒状类固醇和脊椎针,在这些操作中选择使用导管的人较少。没有报告重大的永久性神经损伤,这表明骶管ESIs是治疗腰骶部疼痛的一种安全的介入选择。
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