Complications of fluoroscopically guided caudal epidural injections

Objectives: To assess the incidence of complications of fluoroscopically gu ided caudal epidural injections. Design: A retrospective cohort design study in which chart review was perfo rmed on patients, who presented with radiculopathy and received fluoroscopi cally guided caudal epidural steroid injections. All injections were perfor med consecutively over a 12-mo period. An independent observer reviewed med ical charts, which included a 24-hr post procedure telephone call by an amb ulatory surgery center nurse, who asked a standardized questionnaire about complications after the injections. Physician follow-up office notes 1 to 3 wk after injection along with epidurograms were reviewed. Results: The charts of 139 patients, who received 257 injections, were revi ewed. Complications per injection included 12 episodes of insomnia the nigh t of the injection (4.7%), 9 transient nonpositional headaches that resolve d within 24 hr (3.5%), 8 increased back pain (3.1%), 6 facial flushing (2.3 %), 2 vasovagal reactions (0.8%), 2 episodes of nausea (0.8%), and 1 increa sed leg pain (0.4%). No dural punctures occurred. Conclusions: No major complications occurred. The incidence of minor compli cations was 15.6% per injection. All reactions resolved without morbidity a nd no patient required hospitalization.