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Caudal Epidural Steroid Injection

What does “Caudal Epidural Injection” mean?

Here is the meaning of each word:

  1. Caudal: an opening in the tailbone which leads to the epidural space (space outside of the spinal cord, spinal fluid, and the dura)
  2. Epidural Injection: to deliver medication into the epidural space.

Altogether, “Caudal Epidural Injection” means to deliver medication into the epidural space through an opening in the tailbone.

Why is a Caudal Epidural Injection done?

Caudal epidural injections are often done for a disc herniation or inflamed spinal nerve in the low lumbar area of the spine.

What is the difference between a Caudal and a Lumbar Epidural Injection?

1. Lumbar Epidural Injection (Interlaminar type):

- needle is placed between the lamina bones of the spine

- needle travels through a ligament (ligamentume flavum) connecting thelamina bones before reaching the epidural space

2. Caudal Epidural Injection:

- needle is place into a small opening in the tailbone, called the “sacral hiatus)

- needle travels through the ligament connecting the tailbone to the coccyx

Here are some of the steps of how this injection is done:                                           

  1. The procedure is often done in a Procedure Room or Operating Room
  2. The patient is sometimes given relaxing medication through an intravenous catheter (IV).
  3. The tailbone area is cleaned with a sterile antiseptic solution. Sheets (drapes) are placed around the site.
  4. An X-Ray machine is used to find the opening in the tailbone.
  5. Local anesthetic is injected under the skin.
  6. A small specialized needle is placed into the opening in the tailbone.
  7. A small amount of contrast solution (dye which looks dark on X-Ray) is injected to verify the proper position.
  8. Medication is injected into the caudal epidural space. The medication can be a steroid anti-inflammatory, local anesthetic or a combination of medications.
  9. The needle is removed.
  10. A Band-aid is placed.
  11. The patient is turned on the back and brought to the Recovery Area.

 How long does it take to perform a Caudal Epidural Injection?

 The injection typically takes 5-10 minutes to complete.

What type of benefit can patients gain from a Caudal Epidural Injection?

The results from spinal injections can vary. Caudal Epidural Injections can help with the symptoms from low lumbar disc herniations for weeks to months.