Sacral hiatus corticosteroid injection in the management of radicular pain in adults

Solène Prost (1, 2) , Kaissar Farah (1, 2) , Simon Mazas (3) , Sébastien Pesenti (1, 2) , Stéphane Fuentes (1, 2) , Patrick Tropiano (1, 2) , Jean-Marc Vital (3) , Benjamin Blondel (1, 2)

1 ISM - Institut des Sciences du Mouvement Etienne Jules Marey
2 TIMONE - Hôpital de la Timone [CHU - APHM]
3 Hôpital Pellegrin

Radicular pain is a common reason for patients to consult at back pain clinics. While epidural steroid injections are widely done, some aspects are still controversial. The epidural space can be accessed via a transforaminal approach, an interlaminar route or by passing through the sacral hiatus. The aim of this article is to describe the epidural injection technique through the sacral hiatus that our team uses and to report our experience with it. Beyond the treatment effect, sacral hiatus corticosteroid injection can be useful as a diagnostic test or as an interim solution. Image-guided injection is recommended to ensure optimal positioning of the needle below S3. Sacral hiatus corticosteroid injection is a relevant alternative for treating lumbar radiculopathy in adults.

Mots clés: Radicular pain; Epidural injection; Sacral hiatus

Domaines: Rhumatologie et système ostéo-articulaire; Pharmacologie

Solène Prost, Kaissar Farah, Simon Mazas, Sébastien Pesenti, Stéphane Fuentes, et al.. Sacral hiatus corticosteroid injection in the management of radicular pain in adults. Orthopaedics & Traumatology: Surgery & Research, 2020, 106 (6), pp.1191-1193. ⟨10.1016/j.otsr.2020.05.011⟩. ⟨hal-03187017⟩