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.
A local anesthetic numbs the skin and all the tissue, down to the surface of the lamina portion of the lumbar vertebra bone.
The physician then slides a thicker needle through the anesthetized track. Aided by a fluoroscope, the physician guides the needle toward the epidural space between the L-4 and L-5 vertebral space.
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.
A steroid-anesthetics mix is injected into the foraminal epidural space, bathing the painful nerve root with soothing medication