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Caudal Epidural Injections (Back Injection)

What is a caudal epidural injection?

A caudal epidural injection is similar to a lumbar interlaminar epidural injection. Both types of injections are used to treat pinched or irritated nerves in the low back. The biggest difference is the location that the injection is performed. A caudal epidural injection is done at the lowest part of the low back just above the tailbone area. This injection is most beneficial at targeting pinched nerves in the lowest part of the low back and decreasing pain radiating down the leg.

Who is a candidate for a caudal epidural injection?

A caudal epidural injection is usually preferred for those that have had extensive low back surgery. Previous back surgery can make it difficult to perform an injection at the same level as the surgery was done. This can be due to excessive scarring from the surgery, hardware or screws that were implanted into the spine or excessive arthritis that can form over time. All of these issues block the needle from getting to the irritated nerves. For this reason, a caudal epidural injection is recommended because the nerves are accessed from a point lower than where the surgery was performed.​

What are some of the conditions that these injections are used for?

  • Failed back syndrome

  • Sciatica

  • Spinal stenosis

  • Herniated or bulging disc

  • Bony spurs or arthritis

  • Degenerative disc disease

What to expect during the procedure?

An area right above the tail bone is identified using an x-ray machine called a c-arm. After the area is thoroughly numbed, a needle enters that region into the space where the irritated nerves are located. At this point, medication consisting of numbing medicine and a powerful anti-inflammatory steroid can be injected directly through the needle or a small tube can be threaded through the needle. This tube called a catheter can be used to thread up the spine to get irritated nerves higher than the needle alone can reach. After the the catheter reaches the appropriate level, the numbing medication and steroid are injected through the tubing. This mixture of medication helps to decrease inflammation around the pinched nerves and relieve pain radiating down the leg or legs. 

For more information or to discuss an appropriate treatment plan for your low back pain with one of our specialized pain management physicians, call Saint Louis Spine and Joint Pain Specialists today.

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