J Korean Neurosurg Soc.  2017 Feb;60(2):205-210. 10.3340/jkns.2016.0405.007.

Impact of Position on Efficacy of Caudal Epidural Injection for Low Back Pain and Radicular Leg Pain Due to Central Spinal Stenosis and Lumbar Disc Hernia

• Altun I
• Yuksel KZ

• KMID: 2374882
• DOI: http://doi.org/10.3340/jkns.2016.0405.007

Abstract

OBJECTIVE
This study was performed to evaluate and compare the efficacies of caudal epidural injections performed at prone and lateral decubitus positions.
METHODS
A total of 120 patients suffering from low back pain and radicular leg pain were included and patients were randomly distributed into 2 groups according to the position during injection. In Group 1 (n=60; 32 women, 28 men), caudal epidural injection was performed at prone position, whereas it was implemented at lateral decubitus position in Group 2 (n=60; 33 women, 27 men). Visual analogue scale, Oswestry Disability Index (ODI), walking tolerance (WT) and standing tolerance (ST) were compared in 2 groups before and after injection.
RESULTS
In Group 1, ODI values were higher at 30th minute (p=0.007), 3rd week (p=0.043) and 6th month (p=0.013). In Group 1, ODI, VAS and ST values were improved significantly at all follow-up periods compared to initial values. In Group 1, WT scores were better than initial values at 30th minute, 3rd week and 3rd month. In Group 2, ODI scores at 30th minute, 3rd week, 3rd month and 6th month were improved while VAS and ST scores were improved at all periods after injection. WT scores were better at 30th minute, 3rd week and 3rd month compared to initial WT scores.
CONCLUSION
Our results indicated that application of injection procedure at lateral decubitus position allowing a more concentrated local distribution may provide better relief of pain.

Keyword

Low back pain; Lumbalgia; Treatment; Caudal epidural injection; Position

MeSH Terms

Female
Follow-Up Studies
Hernia*
Humans
Injections, Epidural*
Leg*
Low Back Pain*
Prone Position
Spinal Stenosis*
Walking

Figure

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  Fig. 1 The technique for caudal epidural injection. psis: posterior superior iliac spine, sh: sacral hiatus.

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  Fig. 2 Image demonstrating distribution of injection solution was fair for both sides in prone position.

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  Fig. 3 Image demonstrating the injectate accumulates at the bottom in lateral decubitus position.

Reference

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