Comparison of Ultrasonography and Conventional Fluoroscopy Guided Caudal Epidural Injection in Chronic Low Back Pain

To compare the efficacies of fluoroscopy- and ultrasound (US)-guided caudal epidural steroid injections (CESIs) in patients with chronic low back pain (LBP).

This study included patients with chronic LBP who underwent US- (Group U; n = 90) or fluoroscopyguided (Group F; n = 90) CESI. The procedure time, successful injection rate on the first attempt, complication rate, Oswestry Disability Index (ODI) score, and Numeric Rating Scale (NRS) score before CESI and after 3 weeks and 3 months of CESI were analyzed.

NRS and ODI scores improved at 3 weeks (p < 0.001) and 3 months (p < 0.001) after CESIs. No significant differences were noted between the two groups for the NRS (p=0.22 and p=0.47) and ODI (p=0.58, p=0.22) scores. Moreover, the CESI procedure time was significantly shorter (p < 0.001) and the successful injection rate on the first attempt was significantly higher (p=0.002) in Group U than in Group F. The complication rate difference was statistically insignificant between the two groups (p > 0.05).

Outcomes of US-guided CESI were superior than those of fluoroscopy-guided CESI considering the successful injection rate on the first attempt and procedure time. In addition, US-guided CESI was as effective as fluoroscopy-guided CESI and did not expose patients and practitioners to radiation.