Hasoon Jamal, Viswanath Omar, Orhurhu Vwaire, Abd-Elsayed Alaa
Anesthesiology, Critical Care, and Pain Medicine The University of Texas Health Science Center at Houston.
Creighton University.
Orthop Rev (Pavia). 2025 Apr 22;17:134102. doi: 10.52965/001c.134102. eCollection 2025.
Caudal epidural steroid injections (ESIs) are commonly used to manage lumbosacral radicular pain and axial low back pain. While they are generally considered safe, real-world data on complication rates and patient-reported outcomes remain limited. This study aimed to evaluate the safety profile and short-term effectiveness of caudal ESIs by reviewing a series of randomly selected cases performed over a six-month period.
A retrospective chart review was conducted on 40 randomly selected caudal ESI procedures performed between July 1, 2024, and December 31, 2024. All procedures were performed under fluoroscopic guidance using a corticosteroid mixed with local anesthetic and preservative-free normal saline. Charts were reviewed for procedural complications, including dural puncture, neurological injury, and infection. Outcome data, including starting and post-injection pain scores and patient-reported percent relief, were analyzed in patients with complete follow-up at two weeks or by post-procedure phone call.
There were no documented dural puncture, infection, or permanent neurological injury among the 40 cases. Of the 27 patients with complete follow-up data, the average pain score decreased from 8.6 to 2.9 on the numerical rating scale. The average patient-reported percent relief was 67.4%. A total of 24 patients (88.9%) reported at least 50% relief, 3 patients (11.1%) reported complete (100%) relief, and only 1 patient reported no relief (0%).
Caudal ESIs demonstrated a favorable safety profile and were associated with meaningful short-term pain relief in most patients. These findings support the continued use of caudal ESIs as a safe and effective interventional option for appropriately selected patients with lumbosacral pain.
骶管硬膜外类固醇注射（ESIs）常用于治疗腰骶部神经根性疼痛和下腰部轴向疼痛。虽然它们通常被认为是安全的，但关于并发症发生率和患者报告结局的真实世界数据仍然有限。本研究旨在通过回顾一系列在六个月期间随机选择的病例，评估骶管ESIs的安全性和短期有效性。
对2024年7月1日至2024年12月31日期间随机选择的40例骶管ESI手术进行回顾性病历审查。所有手术均在荧光透视引导下进行，使用皮质类固醇与局部麻醉剂和无防腐剂生理盐水混合。审查病历以查找手术并发症，包括硬膜穿刺、神经损伤和感染。对在两周时完成随访或通过术后电话随访的患者的结局数据进行分析，包括注射前和注射后的疼痛评分以及患者报告的缓解百分比。
40例病例中未记录到硬膜穿刺、感染或永久性神经损伤。在27例有完整随访数据的患者中，数字评分量表上的平均疼痛评分从8.6降至2.9。患者报告的平均缓解百分比为67.4%。共有24例患者（88.9%）报告至少缓解了50%，3例患者（11.1%）报告完全缓解（100%），只有1例患者报告无缓解（0%）。
骶管ESIs显示出良好的安全性，并且在大多数患者中与有意义的短期疼痛缓解相关。这些发现支持继续将骶管ESIs作为一种安全有效的介入选择用于适当选择的腰骶部疼痛患者。
