According to the recent study published in 'Pain and Therapy', the caudal approach with an adjustable catheter was found to be a novel, safe and extremely target-specific treatment for patients with acute radicular pain. It allows the use of small doses of corticosteroids and also makes the procedure free from the risk of significant complications.

Acute lumbosacral radicular syndrome is a medical condition with difficult management. Epidural steroid injections are useful for the management of herniated disc and radiculitis; the transforaminal approach is generally used due to its significant effectiveness and target-specificity. However, the transforaminal approach may result in permanent lower extremity paralysis. The caudal approach with an adjustable catheter has shown promising results in adhesiolysis in chronic low back pain. However, there is lack of data depicting its efficacy in acute radicular pain.

Maria Clemente et al. conducted the study to examine the clinical efficacy of epidural steroid injection by a caudal approach with an adjustable catheter in patients suffering from severe acute radicular pain.

The study included 55 patients with severe acute radiculopathy. The patients received epidural steroid injection by an epidural catheter whose tip can be directed laterally on the selected site. After 1, 3, 6, and 12 months, pain relief, analgesic consumption and the Numerical rating scale (NRS) were observed. The secondary end-points were functional recovery (FR) and analgesic consumption (AC).

NRS score showed a considerable reduction, which was constant every 12 months. After one month, the pain relief was good; which further got better after three months. Inadequate pain relief was observed in a few patients and pain relapsed in only three patients. More than 70% of patients were found to be drug-free at 12 months. The author mentioned the need for further studies or clinical trials to confirm these preliminary findings.