caudal epidural space: lowest portion of the epidural system and is entered through the sacral hiatus. The sacrum is a triangular bone that consists of the five fused sacral vertebrae (S1- S5). It articulates with the fifth lumber vertebra and the coccyx. Caudal epidural and caudal nerve block injections are steroid injections that are given in the coccyx (tailbone or caudal) region to treat chronic lower back pain and chronic pain in the legs. Although both injections aim to relieve pain using a steroid solution, each one is administered differently.
Caudal epidural block is a commonly used technique for surgical anesthesia in children and chronic pain management in adults. It is performed by inserting a needle through the sacral hiatus to gain entrance into the sacral epidural space. Caudal epidural anesthesia has many applications, including surgical anesthesia in children and adults, as well as the management of acute and chronic pain conditions. Success rates of 98%–% can be achieved in infants and young children before the age of puberty, as well as in lean adults.
Caudal regression syndrome is a broad term for a rare complex disorder characterized by abnormal development of the lower (caudal) end of the spine. The spine consists of many small bones (vertebrae) that collectively form the spinal column. 5 However, although evidence is limited, promising outcome from recent studies favoured the value of adjunctive caudal block as a postoperative analgesia strategy in adult urological surgeries. 6.
Adult caudal blockade has fallen from favor in the anesthesia community. The majority of anesthesia providers now use lumbar epidurals and spinals for surgeries that can be done with caudals. Many claim the procedure is difficult to perform and the outcome of the block is unpredictable. Caudal anesthesia has distinct advantages over lumbar. Caudal epidural is a commonly performed regional anesthetic technique in children. In adults, the high-failure rates associated with landmark-based techniques deter its widespread use. Fluoroscopy-guided caudal epidural steroid injections are widely used as a treatment modality in chronic back pain.