Lumbar and caudal epidural corticosteroid injections

Objective: To describe the indications, rationale, techniques, alternatives, contraindications, complications, and efficacy of lumbar and caudal epidural corticosteroid injections. Design: Case reports and retrospective and prospective studies were extensively reviewed to provide detailed descriptions of the clinical features of lumbar and caudal epidural corticosteroid injections. Results: Epidural corticosteroid injections are commonly requested treatments for patients with various low-back or lower-extremity pain syndromes (or both). Most of the reports on the use of this type of treatment are retrospective and noncontrolled. These studies indicate benefit; however, the prospective controlled studies provide varied results about the efficacy of lumbar and caudal epidural corticosteroid injections. Conclusion: A thorough analysis of the few available controlled studies and their limitations indicates that this treatment is probably efficacious for patients with certain lower-extremity radicular pain syndromes when intermediate-term (2 weeks to 3 months) results are assessed after injection, More studies are needed to elucidate further the most beneficial candidates and techniques.