Comparative Evaluation of Caudal Epidural Method to Ultrasound-Guided S1 Transforamen Block in Patient's Lumbar Discectomy with Failed Back Syndrome Symptoms: A Double-Blind Clinical Trial.

Journal: Anesthesiology and pain medicine
Published Date: Dec 29, 2023

Abstract

BACKGROUND: Post-lumbar surgery syndrome (PLSS) refers to persistent or recurrent pain following spinal surgery with an unknown cause. It is commonly associated with epidural fibrosis (EF). Some studies suggest that epidural steroid injection (ESI) can effectively alleviate pain in PLSS, particularly when targeting the S1 nerve root using S1 transforaminal epidural steroid injection (S1-TFESI). A key factor in a successful block is accurately visualizing the first dorsal sacral foramen, and the needle's destination is the dorsal S1 foramen. Although S1-TFESI is often performed under fluoroscopy through the transforaminal route, an alternative to reduce radiation exposure is ultrasound guidance. This study aimed to compare the efficacy of ultrasound-guided caudal epidural steroid injection (CESI) and S1-TFESI in PLSS patients.

Authors

  • Masoud Hashemi
    Anesthesiology Research Center, Emam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Artadokht Khoshooei
    Clinic of Pain, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Alireza Amanollahi
    Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Sogol Asgari
    Anesthesiology Research Center, Shahid Beheshti University of Medical Scienes, Tehran, Iran.

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