Cervical & Lumbar Epidural Steroid Injections
Cervical Epidural Steroid Injections
These injections relieve pain in the neck, shoulders, and arms caused by a pinched nerve (or nerves) in the cervical spine. Conditions such as herniated discs and spinal stenosis can compress nerves, causing inflammation and pain. The medication injected helps decrease the swelling of the nerves.
Procedure
Patient Sedated
The procedure is performed with the patient lying down. A region of skin and tissue of the neck is numbed with a local anesthetic delivered through a small needle.
Needle Inserted
Using x-ray guidance (also called fluoroscopy), the physician guides a larger needle to the painful area of the neck. The needle is inserted into the epidural space, which is the region through which spinal nerves travel.
Contrast Dye Injected
Contrast dye is injected into the space to make sure the needle is properly positioned near the irritated nerve or nerves.
Steroid Injected
A combination of an anesthetic and cortisone steroid solution is injected into the epidural space. The steroid is an anti-inflammatory medication. It is absorbed by the inflamed nerves to decrease swelling and relieve pressure. The needle is removed and a small bandage is applied.
Post Procedure
The patient is moved to a recovery suite and discharged with post procedure instructions. Some patients may only need one injection, but it may take two or three injections (administered weeks apart) to provide significant pain relief.
Lumbar Epidural Steroid Injection
Lumbar Epidural Steroid Injection (ESI) is performed to relieve low back and radiating leg pain. Steroid medication used during this procedure can reduce swelling and inflammation.
Many patients get significant relief from only one or two injections.
Procedure
Patient Positioned
Patient will be asked to lay face down on their stomach. A cushion will be placed under the abdomen to provide comfort and to flex the back. This position allows the spine to be open and allow access to the epidural space.
Tissue Anesthetized
A local anesthetic is used to numb the skin. All the tissue down to the surface of the lamina portion of the lumbar vertebrae bone is anesthetized. The physician slides a thicker needle through the anesthetized track.
Fluoroscopic Guidance
Using a fluoroscope for guidance, the physician slides the needle toward the epidural space between the vertebrae. A contrast solution is injected. The physician uses the fluoroscope to confirm the correct location of the needle tip.
Steroids Injected
A steroid-anesthetics mix is injected into the epidural space, bathing the painful nerve root with soothing medication.
Post Procedure
The needle is removed, and a small bandage is applied to cover the tiny needle surface wound. In some cases, it may be necessary to repeat the procedure as many as three times to get the full benefit of the medication.