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Caudal Epidural Steroid Injection
A caudal epidural steroid injection (ESI) is a minimally invasive procedure commonly used to treat pain and inflammation in the lower back (lumbar) and legs. It involves injecting a combination of local anesthetic (numbing medication) and corticosteroid (anti-inflammatory medication) into the epidural space in the lower back.
Here’s an overview of how the procedure is typically performed:
Preparation: Before the injection, the patient may be asked to change into a hospital gown and lie face down on an examination table. Vital signs such as blood pressure, heart rate, and oxygen levels may be monitored throughout the procedure.
Sterilization: The skin on the lower back is cleaned and sterilized with an antiseptic solution to reduce the risk of infection.
Anesthesia: A local anesthetic is administered to numb the skin and tissues around the injection site. This helps reduce discomfort during the procedure.
Needle insertion: Using fluoroscopic guidance (live X-ray imaging), the healthcare provider inserts a thin needle through the skin and into the epidural space in the lower back. The caudal approach involves inserting the needle through the sacral hiatus, a small opening at the base of the sacrum (the triangular bone at the base of the spine).
Medication injection: Once the needle is correctly positioned in the epidural space, a mixture of corticosteroid medication (such as triamcinolone or methylprednisolone) and a local anesthetic (such as lidocaine or bupivacaine) is injected. The corticosteroid helps reduce inflammation and relieve pain, while the local anesthetic provides immediate pain relief.
Post-procedure care: After the injection, the patient is typically monitored for a short period to ensure there are no immediate complications. Some patients may experience temporary numbness or weakness in the legs due to the effects of the local anesthetic, but this usually resolves quickly.
Often used as part of a comprehensive treatment plan
Caudal epidural steroid injections are often used as part of a comprehensive treatment plan for conditions such as lumbar disc herniation, spinal stenosis, degenerative disc disease, and sciatica. The goal is to reduce pain and inflammation in the affected area, allowing patients to participate in physical therapy and other rehabilitative activities more comfortably.
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