An epidural injection is the injection of the corticosteroid and/or local anesthetic into the epidural space in the spine. The spinal cord is enclosed within a sac of fluid, which is contained by a membranous layer called the dural sac. The epidural space is the space between this dural sac and the bony vertebral column.
The two most common types of epidural injections being administered are spinal and caudal. In spinal conditions, such as nerve root inflammation from a disc injury, the needle is introduced at the level of the spine, which is the cause of the symptoms.
Caudal epidurals involve the needle being introduced into the sacral hiatus, located just above the coccyx (tail bone). The fluid is introduced slowly over 20 to 40 minutes. Administering the medication in this way minimizes the chances of ill effects or pain.
With any injection there are risks. The risks with caudal epidural are small, and relate to the procedure itself rather than the material injected. The most common side effect is a temporary increase in pain in the back or leg. Headache occurs in about one percent of injections. Allergy to the anesthetic is possible. As with any injection through the skin, it is possible for bacteria to gain entry causing an infection, but the risk of this is small. It is theoretically possible that a nerve could be damaged, but by using the caudal rather than the spinal point of needle entry this likelihood is almost impossible. Certain other effects can occur if the injection is inadvertently given in the spinal fluid. Correct technique will lessen this possibility.
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