Epimed International has developed a line of epidural catheters to be directed under fluoroscopy (X-ray). The physician inserts the Spring Guide Catheter into the epidural space at the nearest convenient area to the affected region. Due to common anatomy, this is usually the caudal canal, via the Sacral Hiatus. The Sacral Hiatus is a natural opening in the spine near the end of the tailbone. Aided by real-time X-ray imaging, the catheter can be seen on the monitor and directed precisely to the affected nerve root (see Figure 1).
Epimed catheters have a soft, non.damaging tip to glide off sensitive areas, and a strong body to steer through the epidural space. Once the tip of the catheter is in place, medication can be injected to relieve pain at the source.
 

What to expect during the procedure

After the nursing staff has prepared you for your procedure, you will be taken into the operating or procedure room. You may be placed on a table that is more compatible with the C-arm (fluoroscopy machine).
The physician will inject local anesthetic in the skin where the catheter will be introduced. This may cause a very short pinching sensation. Mild sedation will also be administered to reduce potential discomfort. General anesthesia is not an option as your participation in the procedure is critical.

Once the local anesthetic sets in, an epidural needle will be inserted. Through this needle, the catheter is advanced to the injection site. During the procedure, you will be asked how a certain stimulus may feel, or to move your toes, etc. The movement of the catheter is continuously monitored with the C-arm to assure safe and effective positioning. The make-up of the epidural space is as unique as your fingerprints, so predicting the ease of the placement can be difficult. Your physician will inject contrast material to see an outline of the epidural space on the monitor (commonly referred to as an Epidurogram). The contrast material is simply a fluid that shows up on x-ray, and has no adverse effect on the human body in this procedure.