Those patients scheduled for afternoon procedures should eat a normal breakfast (. cereal, toast, etc.) and a light lunch, such as a sandwich and soup. You may take your regularly scheduled medications; however, there are some exceptions. Hold any anticoagulants, such as Coumadin, Heparin or Lovenox, for three days prior to your procedure. Hold Glucophage the day of the procedure and 48 hours post procedure. If you are having a test injection, hold your pain medication. Please take all your medications on the day of procedure other than the ones you have been informed to stop. Please call the University of Maryland Spine staff prior to your appointment if you have any questions or concerns.
You will lie on your stomach on a procedure table with pillows positioned for optimal comfort. After the back area is prepped with special soap, local anesthetic numbing medicine will be injected over a small area of the skin, which may sting for a few seconds. Next, a special needle will be inserted and guided via X-ray to the epidural space. Dye is then injected to confirm proper location into the epidural space. Finally, the healthcare provider injects the medication (such as a steroid or anesthetic). You may feel pressure in the back or down the leg as the medication is injected.
Caudal epidural steroid injections involve injecting a steroid into the epidural space, where the irritated nerve roots are located. The caudal injection is performed through the sacral opening and is used to treat low back pain. This injection includes both a long-lasting steroid and an anesthetic (lidocaine, bupivacaine). The steroid reduces inflammation and irritation, while the anesthetic interrupts the pain-spasm cycle and nociceptor transmission (Boswell 2007). The medicines spread to the most painful levels of the spine, reducing inflammation and irritation. The entire procedure usually takes less than 15 minutes.