backInjectionThe epidural space of a spine is the space between the outermost layer and the bone. The epidural space is outside of the spinal cord and extends from the base of the skull to the tailbone. Nerve roots exit from the spinal cord and then come together to form nerves. Epidural and nerve root injections are performed under x-ray guidance in a procedure suite for precise location. Conscious sedation may be provided upon prior approved request. The physician will then deliver a local anesthetic. Using a spinal needle, the physician then delivers the corticosteroid into the epidural space or selected nerve root. Relief of pain and inflammation may take five to seven days, however maximum relief may take up to two weeks. Epidural and nerve root injections provide long term relief, lasting weeks to months.

 

Reason for the procedure

This injection is performed to relieve spinal pain as well as any radicular pain. The steroid medication can reduce the swelling and inflammation caused by spinal conditions such as spinal stenosis, radiculopathy, sciatica and herniated discs.

There are three locations for an epidural:

This injection is administered to relieve pain in the neck, shoulders, and arms caused by pinched nerve(s) in the cervical spine.  Conditions such as herniated discs, spinal stenosis, or radiculopathy can compress nerves, causing inflammation and pain.  The medication injected helps…

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epiduralThis injection procedure is performed to relieve mid back pain. The steroid medication can reduce the swelling and inflammation caused by spinal conditions, such as spinal stenosis, radiculopathy, sciatica and herniated discs. In some cases it may be necessary to repeat the procedure as many as three times to get the full benefit of the medication. However many patients get significant relief from only one or two injections.

Positioning the patient

In this procedure, the patient lays face down. A cushion under the stomach area provides comfort and flexes the back. In this position the spine will open, allowing for easier access to the epidural space. A fluoroscope assists the physician in locating the appropriate lumbar vertebra and nerve root.

STEP 1

A local anesthetic numbs the skin and all the tissue, down to the surface of the lamina portion of the lumbar vertebra bone.

STEP 2

The physician then slides a thicker needle through the anesthetized track. Aided by a fluoroscope, the physician guides the needle toward the epidural space most commonly between the T8/9 or T9/10 vertebrae.

STEP 3

A contrast solution is injected so the physician can use the fluoroscope to see the painful areas and to confirm the correct location of the needle tip.

STEP 4

A steroid-anesthetics mix is injected into the foraminal epidural space, bathing the painful nerve root with soothing medication

This injection procedure is performed to relieve low back and radiating leg pain. The steroid medication can reduce the swelling and inflammation caused by spinal conditions, such as spinal stenosis, radiculopathy, sciatica…

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Here are download The Epidural Procedure Instructions.
The procedure

The patient may be asked to change in a gown for better access during the procedure. Patient will be asked to lie face down on the table. You will be fully awake for the procedure unless you have elected sedation. The procedure will be performed using a special x-ray machine (fluoroscopy). The procedure usually takes 10-15 minutes depending on the approach used to place the steroid.

The area to be injected will be cleansed with a Chloraprep solution. A Sterile draping of a square cloth-like material is placed on your skin, around the area where the procedure will be done. There are several approaches the physician may choose to take Transforaminal (from the side), Interlaminar (straight), or Caudal (below). The area to be injection is numbed with a medication to help make the procedure as comfortable as possible. This local anesthetic helps numb the skin and tissues where the needle will be inserted. You may have some discomfort during the injection. If you experience discomfort, tell your physician. Once the area is numb, a needle will be place alongside the nerve root and a contrast die is injected. After the contrast die is injected a small amount of anesthetic and steroid is injected.

After the procedure

A band aid will be placed over injection site. You may stay in the recovery area and rest quietly until you feel well enough to leave. For some people, this is 10 minutes; for others, it can be longer.