Diário da Espinha

Efficacy and Tolerance of Caudal Epidural Injection. A Retrospective Study of 201 Patients

Abstract

Sylvain Mathieu, Marion Couderc, Zuzana Tatar, Anne Tournadre, Sandrine Malochet-Guinamand, Jean-Jacques Dubost and Martin Soubrier

Objective: Sacrococcygeal epidural (SE) injection is indicated for the relief of lumbo sciatic pain, but is not regularly performed in daily practice. The objective of this study was to evaluate the efficacy and tolerance of SE injections.

Design: Retrospective study with a questionnaire sent to patients who underwent the procedure between January 2007 and September 2012.

Results: A total of 558 patients (202 men: 36%) underwent the procedure. 57 were excluded from the study (28 for an incorrect postal address, 15 because they had died, 7 because no injection was administered, 5 for cognitive impairment and 2 who refused to respond).

Among the 201 respondents (201/501: 40.1%), 53% (n=107) reported an improvement in pain, 64% in less than 5 days after the procedure (68/107), with pain relief lasting for over 6 months in 63% (65/104). 87 patients reported an improvement in walking (87/192: 45%) and in quality of life. Considering that all non-responders had an injection failure, we obtained 19% of success in our sample of 558 patients. The injection was well tolerated by 85% of patients (162/190). 37% of patients (72/194) experienced pain during the procedure, with a mean VAS pain score of 6.8 ± 2.5 mm. 53% (102/191) would agree to have a new injection.

Conclusion: Sacrococcygeal epidural injection provided pain relief in more than half of patients and the procedure was well tolerated. This procedure merits a more prominent place in the management of symptomatic lumbar canal stenosis.