Epidural steroid injections are generally very safe, but there are some rare potential complications. One of the most common risks is for the needle to go too deep and cause a hole in the dura, the tissue that surrounds the spinal cord and nerve roots. When this occurs spinal fluid can leak out through the hole and cause a headache . This headache can be treated with bedrest, or with a blood patch. A blood patch involves drawing some blood from the vein and the injecting it over the hole in the dura. The blood forms a seal over the hole and prevents any further fluid from leaking out.
A local anesthetic be injected into your skin to make it numb. The epidural needle will then be inserted through the numbed skin and slowly advanced into the epidural space using fluoroscopy (live X-rays) to guide the needle. Once the needle is in the epidural space, a small amount of contrast will be injected under live X-ray to ensure that the medication will spread properly. After this, the corticosteroid will be slowly injected into the epidural space. Once the injection is complete, the needle will be withdrawn and a dressing will be placed over the injection site.
The caudal approach to the epidural space involves the use of a Tuohy needle, an intravenous catheter, or a hypodermic needle to puncture the sacrococcygeal membrane . Injecting local anaesthetic at this level can result in analgesia and/or anaesthesia of the perineum and groin areas. The caudal epidural technique is often used in infants and children undergoing surgery involving the groin, pelvis or lower extremities. In this population, caudal epidural analgesia is usually combined with general anaesthesia since most children do not tolerate surgery when regional anaesthesia is employed as the sole modality.