Complications of fluoroscopically guided caudal epidural injections

Am J Phys Med Rehabil. 2001 Jun;80(6):416-24. doi: 10.1097/00002060-200106000-00005.


Objectives: To assess the incidence of complications of fluoroscopically guided caudal epidural injections.

Design: A retrospective cohort design study in which chart review was performed on patients, who presented with radiculopathy and received fluoroscopically guided caudal epidural steroid injections. All injections were performed consecutively over a 12-mo period. An independent observer reviewed medical charts, which included a 24-hr post procedure telephone call by an ambulatory 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 reviewed. Complications per injection included 12 episodes of insomnia the night of the injection (4.7%), 9 transient nonpositional headaches that resolved 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 increased leg pain (0.4%). No dural punctures occurred.

Conclusions: No major complications occurred. The incidence of minor complications was 15.6% per injection. All reactions resolved without morbidity and no patient required hospitalization.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fluoroscopy
  • Humans
  • Injections, Epidural / adverse effects*
  • Injections, Epidural / methods
  • Male
  • Medical Records
  • Middle Aged
  • Radiculopathy / drug therapy*
  • Retrospective Studies
  • Steroids / administration & dosage*
  • Surveys and Questionnaires


  • Steroids