Sheared or break of caudal catheters after epidural steroid injection

Abstract

Chronic back and radicular pain is a common problem in the general population. It is often managed conservatively but at times requires surgical intervention. An epidural steroid injection is one of the most common interventions for treating this condition. The injection is performed either via an interlaminar, transforaminal, or a caudal approach. To improve the spread of the medication injected, a catheter is threaded via the sacral hiatus to target the lower lumbar space. A catheter is often used in patients suffering from failed back syndrome. The use of catheter, usually uneventful, can be complicated by dural puncture, subdural placement, or intravascular injection. The more unusual complications of catheter shearing and breakage have been reported. Knowing the mechanisms of catheter shearing may prevent it or manage it after it happens.