This outpatient procedure is an injection of a steroid-anesthetic medication through an opening in the sacrum. The medication can reduce swelling and inflammation of irritated spinal nerves. The injection takes only a few minutes to complete.
In preparation for the procedure, the patient lies face down. A cushion is placed under the abdomen to elevate the sacrum. The physician administers a local anesthetic to numb the skin and the tissue above the small opening at the base of the sacrum. This opening is called the sacral hiatus. When the area is numb, the physician guides a needle through the sacral hiatus and into the caudal epidural space. This is the open space in the sacrum where the irritated nerve roots are located. The physician injects contrast solution through the needle. The physician uses a fluoroscope (a type of x-ray device) to confirm that the tip of the needle is positioned correctly within the epidural space. After the needle's position has been confirmed, the physician injects a steroid-anesthetic medication. This medication bathes the irritated nerve roots. It will help alleviate the patient's pain. When the procedure is complete, the physician removes the needle and bandages the insertion site. The patient may feel significant relief after one injection. Some patients may need multiple injections before they feel the full benefit of the medication.