Skip to main content

Caudal Epidural Injection

  • Chapter
  • First Online:
Deer's Treatment of Pain

Abstract

Caudal epidural injections have been used in medicine for many years and extensively in pediatrics, obstetrics, and interventional pain medicine. Pain management physicians typically inject local anesthetics with or without corticosteroids in the caudal epidural space to treat pain from spinal stenosis, failed back surgery syndrome, lumbar radiculopathy, and other etiologies of low back pain. The caudal approach to the epidural space offers several advantages compared to other epidural injections. It is considered safer, can be performed with or without fluoroscopy, and is an excellent approach for patients who have undergone previous back surgeries.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Recommended Reading

  1. Brown TC. History of pediatric regional anesthesia. Paediatr Anaesth. 2012;22(1):3–9.

    Article  CAS  PubMed  Google Scholar 

  2. Conn A, Buenaventura RM, Datta S, Abdi S, Diwan S. Systematic review of caudal epidural injections in the management of chronic low back pain. Pain Physician. 2009;12(1):109–35.

    PubMed  Google Scholar 

  3. Friedman JH, Dighe G. Systematic review of caudal epidural injections in the management of chronic back pain. R I Med J. 2013;96(1):12–6.

    Google Scholar 

  4. Karkera MM, Harrison DR, Aunspaugh JP, Martin TW. Assessing caudal block concentrations of bupivacaine with and without the addition of intravenous fentanyl on postoperative outcomes in pediatric patients: a retrospective review. Am J Ther. 2016;23(3):e792–8.

    Article  PubMed  Google Scholar 

  5. Kaye AD, Manchikanti L, Abdi S, et al. Efficacy of epidural injections in managing chronic spinal pain: a best evidence synthesis. Pain Physician. 2015;18(6):E939–1004.

    PubMed  Google Scholar 

  6. Manchikanti L, Singh V, editors. Interventional techniques in chronic spinal pain. Paducah: American Society of Interventional Pain Physicians; 2007.

    Google Scholar 

  7. Manchikanti L, Cash KA, McManus CD, Pampati V, Abdi S. Preliminary results of a randomized, equivalence trial of fluoroscopic caudal epidural injections in managing chronic low back pain: part 4--spinal stenosis. Pain Physician. 2008;11(6):833–48.

    PubMed  Google Scholar 

  8. Manchikanti L, Singh V, Cash KA, Pampati V, Damron KS, Boswell MV. A randomized, controlled, double-blind trial of fluoroscopic caudal epidural injections in the treatment of lumbar disc herniation and radiculitis. Spine (Phila Pa 1976). 2011;36(23):1897–905.

    Article  Google Scholar 

  9. Manchikanti L, Cash KA, McManus CD, Pampati V, Fellows B. Results of 2-year follow-up of a randomized, double-blind, controlled trial of fluoroscopic caudal epidural injections in central spinal stenosis. Pain Physician. 2012a;15(5):371–84.

    PubMed  Google Scholar 

  10. Manchikanti L, Singh V, Cash KA, Pampati V, Datta S. Fluoroscopic caudal epidural injections in managing post lumbar surgery syndrome: two-year results of a randomized, double-blind, active-control trial. Int J Med Sci. 2012b;9(7):582–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Manchikanti L, Falco FJ, Pampati V, Cash KA, Benyamin RM, Hirsch JA. Cost utility analysis of caudal epidural injections in the treatment of lumbar disc herniation, axial or discogenic low back pain, central spinal stenosis, and post lumbar surgery syndrome. Pain Physician. 2013a;16(3):E129–43.

    PubMed  Google Scholar 

  12. Manchikanti L, Abdi S, Atluri S, et al. An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: guidance and recommendations. Pain Physician. 2013b;16(suppl 2):S49–283.

    PubMed  Google Scholar 

  13. Manchikanti L, Pampati V, Falco FJ, Hirsch JA. Assessment of the growth of epidural injections in the medicare population from 2000 to 2011. Pain Physician. 2013c;16(4):E349–64.

    PubMed  Google Scholar 

  14. Manchikanti L, Benyamin RM, Falco FJ, Kaye AD, Hirsch JA. Do epidural injections provide short- and long-term relief for lumbar disc herniation? A systematic review. Clin Orthop Relat Res. 2015;473(6):1940–56.

    Article  PubMed  Google Scholar 

  15. Parr AT, Manchikanti L, Hameed H, et al. Caudal epidural injections in the management of chronic low back pain: a systematic appraisal of the literature. Pain Physician. 2012;15(3):E159–98.

    PubMed  Google Scholar 

  16. Rathmell JP. Atlas of image-guided intervention in regional anesthesia and pain medicine. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2012.

    Google Scholar 

  17. Rho ME, Tang CT. The efficacy of lumbar epidural steroid injections: transforaminal, interlaminar, and caudal approaches. Phys Med Rehabil Clin N Am. 2011;22(1):139–48.

    Article  PubMed  Google Scholar 

  18. Silva M, Halpern SH. Epidural analgesia for labor: current techniques. Local Reg Anesth. 2010;3:143–53.

    PubMed  PubMed Central  Google Scholar 

  19. Waldman SD. Atlas of interventional pain management. 3rd ed. Philadelphia: Saunders Elsevier; 2009.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Walia, A.A., Tran, H., DuBose, D. (2019). Caudal Epidural Injection. In: Deer, T., Pope, J., Lamer, T., Provenzano, D. (eds) Deer's Treatment of Pain. Springer, Cham. https://doi.org/10.1007/978-3-030-12281-2_55

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-12281-2_55

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-12280-5

  • Online ISBN: 978-3-030-12281-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics