Spine epidural and sacroiliac joints injections--when and how to perform

Eur J Radiol. 2015 May;84(5):777-82. doi: 10.1016/j.ejrad.2014.05.039. Epub 2014 Jun 7.


Objectives: To review the state-of-the-art of image-guided techniques used to treat painful syndromes of the lower back, their indications, how they should be performed, their related risks and the expected results.

Methods: We describe the actual standards about image-guided infiltrative therapies both on spine and on sacroiliac joints.

Results: Both spinal epidural and sacroiliac injections appear useful in a large percentage of treated patients to get control of the perceived pain. Performing these therapies under CT or fluoroscopic guidance is the best and safest way to obtain satisfactory results because it is possible to target the use of drugs directly to the involved painful structures.

Conclusions: Image-guided injections of the epidural space and of the sacroiliac joints are effective techniques for the treatment of pain; their effectiveness is sometimes not lasting for long periods of time but considering the low associated risk when performed by trained personnel, they can be easily repeated.

Keywords: Epidural; Epidural space; Injections; Pulsed radiofrequency treatment; Sacroiliac joint; Spine.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Anesthesia, Caudal* / methods
  • Evidence-Based Medicine
  • Female
  • Humans
  • Low Back Pain / complications
  • Low Back Pain / diagnostic imaging
  • Low Back Pain / drug therapy*
  • Male
  • Practice Guidelines as Topic
  • Radiography, Interventional*
  • Sacroiliac Joint / innervation
  • Sacroiliac Joint / physiopathology*
  • Treatment Outcome


  • Adrenal Cortex Hormones