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Caudal Epidural Steroid Injection: Ultrasound 

Caudal Epidural Steroid Injection: Ultrasound
Chapter:
Caudal Epidural Steroid Injection: Ultrasound
Source:
Multimodality Imaging Guidance in Interventional Pain Management
Author(s):

Imanuel R. Lerman

DOI:
10.1093/med/9780199908004.003.0025

Ultrasound guidance can facilitate caudal epidural steroid injection by providing a clear view of the sacrum, the sacral hiatus, and the needle as it is advanced through the sacrococcygeal ligament into the sacral hiatus. Using ultrasound guidance for the initial needle insertion can eliminate the exposure of the physician and patient to ionizing radiation. However, the use of ultrasound guidance as a sole imaging technique for caudal epidural steroid injection does have disadvantages. Contrast fluoroscopic guidance is necessary to visualize the needle once it passes under the apex of the sacral hiatus to confirm that the needle tip is extradural and indeed extravascular. The use of ultrasound and fluoroscopic guidance takes advantage of each imaging modality to enhance the safety and accuracy of the caudal epidural steroid injection.

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