Epiduroscopy and Epidural Steroid Injections

摘要

To the Editor:-We read with interest the two case reports by Dr. Heavner et al. in which the introduction of an epiduroscope for placement of hyaluronidase, local anesthetic, and steroids in the lower lumbar epidural space led to the apparent disruption of venous wall integrity. Unintended vascular uptake of dye was documented on fluoroscopy. The case reports raise several concerns about the value of using an epiduroscope to place medication in this manner. The evidence in the literature does not support the practice of using an epiduroscope to perform a caudal injection as a means to improve outcome, when compared with a fluoroscopically guided injection via a catheter or needle