Epidural Steroid Injection

Because it is suspected that your pain may be related to inflamed and irritated spinal nerves, your doctor has recommended an epidural steroid injection.

The medication that will be injected includes a steroid (long-acting cortisone type medication) and a local anesthetic.  The actions of these medications are to reduce pain, inflammation and swelling.

The local anesthetic may provide temporary, immediate relief.  The steroid may take anywhere from a few days to a week to start working but is intended to provide extended relief.  In some cases it may be necessary to repeat the process as many as three times to get the full benefit of the medication.  However, some patients get significant relief from only one or two injections.  Treatments are done ten to fourteen days apart.

An Epidural Steroid Injection indicates that the medication will be put into the fatty cushion layer that surrounds the spinal nerve roots and lines the spinal canal.

A Transforaminal Epidural Steroid Injection  indicates that the approach used to enter the epidural space is through the foramen.  The foramen is an opening on either side of the spinal column through which the spinal nerves exit.  This approach allows medication to be targeted as precisely as possible near the pain-generating nerve and/or disc.

A Selective Nerve Root Injection is a transforaminal epidural steroid injection.  The medication will be deposited in such a way that a selected nerve sheath will be coated with the medication.

About the procedure:
A nurse will walk into the procedure room with you and help you get positioned.  Your blood pressure and heart rate will be monitored throughout the procedure.  You may be given IV medication as a relaxant and pain reliever, but for safety you will remain awake during the procedure.

Your skin will be washed with an antiseptic.  A local anesthetic will be used to numb the area to be treated.  X-ray imaging (fluoroscopy) will be used to assure proper placement of the needle and medication.  When the medication is injected you may feel an achy, pressure sensation.
A nurse will walk with you to the recovery area when your procedure is complete.

After the procedure:
You will remain in recovery for a brief time before you are discharged.
You will be given printed home care instructions to take with you.

 

Types of Epidural Injections:
 Caudal Epidural Steroid Injection: Is an epidural steroid injection that targets the bottom part of the spine near sacrum and coccyx (tailbone).
 Interlaminar Epidural Steroid Injection: Interlaminar epidural steroid injection indicates the approach used to enter the epidural space is between the bones of the vertebral arch or lamina of the spinal column.
 Transforaminal Epidural Steroid Injection: A transforaminal epidural steroid injection indicates the approach used to enter the epidural space is through the foramen. The foramen is an opening on either side of the spinal column through which the spinal nerves exit. This approach allows the medication to be targeted as precisely as possible near the pain generating nerve and/or disc.
 Nerve Root/Nerve Sheath Injection: A nerve root injection/nerve sheath injection is a transforaminal epidural steroid injection. The medication will be deposited in such a way that a selected nerve sheath will be coated with the medication.

 

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