Epidural administration of corticosteroids is one of the commonly used interventions in managing low back pain with or without radiculopathy. Approaches used to access the lumbar epidural space include the caudal, interlaminar, and transforaminal injections. Reports of effectiveness have varied from 18% to 90%. However, most of the analyses have failed to separate the three approaches, not only mixing the various procedures but also results and outcomes. Recent guidelines by the American Society of Interventional Pain Physicians and others have evaluated effectiveness of caudal epidural steroid injections (ESIs), transforaminal, and interlaminar injections separately. The consensus from these reviews is that caudal ESIs are superior to the interlaminar epidural injections and equal to transforaminal epidural injections. In addition, the response to epidural injections for various pathologic conditions (disc herniation and/or radiculitis, discogenic pain without disc herniation, spinal stenosis, postsurgery syndrome) is variable. The systematic reviews indicated Level I evidence for caudal ESIs in managing disc herniation or radiculitis, and discogenic pain without disc herniation or radiculitis. They also indicated evidence is Level II-1 or II-2 evidence for caudal epidural injections in managing pain of postlumbar surgery syndrome and lumbar spinal stenosis. They also provided strong recommendations of 1B or 1C for caudal ESIs in managing pain secondary to disc herniation and radiculitis, or discogenic pain without disc herniation or radiculitis, postlumbar laminectomy syndrome, and spinal stenosis.
Techniques in Regional Anesthesia and Pain Management – Elsevier
Published: Oct 1, 2009
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.
Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.
All the latest content is available, no embargo periods.
“Hi guys, I cannot tell you how much I love this resource. Incredible. I really believe you've hit the nail on the head with this site in regards to solving the research-purchase issue.”Daniel C.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud
“I must say, @deepdyve is a fabulous solution to the independent researcher's problem of #access to #information.”@deepthiw
“My last article couldn't be possible without the platform @deepdyve that makes journal papers cheaper.”@JoseServera