Turkish Neurosurgery 2021 , Vol 31 , Num 1
Comparison of Ultrasonography and Conventional Fluoroscopy Guided Caudal Epidural Injection in Chronic Low Back Pain
Serkan SENKAL1,Ender SIR2
1University of Health Sciences, Gulhane Medical Faculty, Department of Anesthesiology and Reanimation, Ankara, Turkey
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

Corresponding author : Ender SIR, endersir@gmail.com