The sacrococcygeal approach is the simplest epidural infiltration technique and has one of the lowest complications rates. The caudal epidural infiltration is currently one of the regional analgesia techniques that are mostly performed for chronic lumbar pain.
This infiltration consists of an injection with a mixture of local anesthetics and corticosteroids in the epidural space in the lower part of the spinal canal of the sacral region. The main indication is the lumbar pain irradiated to the lower extremities linked to the narrow lumbar canal, in the case of discopathies and in patients with postoperative fibrosis.
The improvement experienced by the patient is due to the anti-inflammatory effect (corticoids reverse the biochemical and enzymatic cascade secondary to local inflammation); to the mechanical effect (by decompression of a nervous structure by the injected liquid volume) and because it improves the local vascularization and produces analgesia.
In vertebral pathology, epidural infiltrations do not play a role as the first line treatment, but they are used due to the failure of other less aggressive techniques.