How are caudal epidural steroid injections (ESIs) administered?

Updated: Aug 06, 2018
  • Author: Boqing Chen, MD, PhD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Caudal lumbar epidural injections may be performed by inserting a needle through the sacral hiatus into epidural space at the sacral canal. Because of the large area in the caudal space and the distance from the nerve roots, larger volumes of injectate are required to deliver drug to the area of the pain generator. (See image below.)

Caudal approach, lateral view. Caudal approach, lateral view.

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