Issue release date: 12.11.2024
2Gulhane Training and Research Hospital, Department of Algology and Pain Medicine, Ankara, Turkey DOI : 10.5137/1019-5149.JTN.31515-20.2 AIM: To compare the efficacies of fluoroscopy- and ultrasound (US)-guided caudal epidural steroid injections (CESIs) in patients with chronic low back pain (LBP).
MATERIAL and METHODS: This study included patients with chronic LBP who underwent US- (Group U; n = 90) or fluoroscopyguided (Group F; n = 90) CESI. The procedure time, successful injection rate on the first attempt, complication rate, Oswestry Disability Index (ODI) score, and Numeric Rating Scale (NRS) score before CESI and after 3 weeks and 3 months of CESI were analyzed.
RESULTS: NRS and ODI scores improved at 3 weeks (p<0.001) and 3 months (p<0.001) after CESIs. No significant differences were noted between the two groups for the NRS (p=0.22 and p=0.47) and ODI (p=0.58, p=0.22) scores. Moreover, the CESI procedure time was significantly shorter (p<0.001) and the successful injection rate on the first attempt was significantly higher (p=0.002) in Group U than in Group F. The complication rate difference was statistically insignificant between the two groups (p>0.05).
CONCLUSION: Outcomes of US-guided CESI were superior than those of fluoroscopy-guided CESI considering the successful injection rate on the first attempt and procedure time. In addition, US-guided CESI was as effective as fluoroscopy-guided CESI and did not expose patients and practitioners to radiation.
Keywords : Caudal anesthesia, Epidural injections, Fluoroscopy, Interventional ultrasonography, Low back pain