Epidural Steroid Injection / Selective Nerve Root Block

 

What is it?

An injection performed under fluoroscopy (x-ray) to confirm a specific diagnosis and to decrease nerve root pain. The pain is relieved as the corticosteroid decreased inflammation of the nerve roots. An anesthetic agent is injected with the corticosteroid into the epidural space and/or the neural foramen where the nerve root exits the spine.

How is it done?

An I.V. will be started in your hand or arm and local anesthetic will be given at the site of injection.Interlaminar Epidural Steroid Injection: The epidural space is inside the bony canal of the spine and outside the dura (covering of the spinal cord). This space runs the length of the spine. A needle is inserted into the epidural space of the cervical, thoracic, lumbar or caudal spine. The steroid medication is then injected into this space.Transforaminal Epidural Steroid Injection & Selective Nerve Root block: A specific spinal nerve root is located under fluoroscopy. A needle is then introduced into the foramen of the nerve root. Steroid medication is then injected into the area bathing the nerve root.

Expected results:

A prolonged decrease in or relief of pain can occur. The steroid medication may be unable to overcome the inflammation and pain if the inflamed area is significant. Onset of relief is usually within 2-days, but may take up to 2-weeks to reach full effectiveness.

How long does it take?

The injection takes about 30 minutes, plus approximately 30 minutes recovery time. Please take your usual medications with small sips of water unless otherwise instructed.

Risks involved:

Risks include increased pain, headache, bleeding, infection, a reaction to any medications used, nerve damage, paraplegia/quadriplegia, or death.

Side effects:

  • Mild back or neck ache lasting a few days
  • Bruising of the skin and tenderness at the injection site
  • Short-term headache, salt retention with temporary weight gain
  • Rare emotional changes: elation, hyperactivity, anger, depression

 

  • YOU WILL NEED SOMEONE TO DRIVE YOU TO AND FROM THE SURGICAL CENTER
  • NO FOOD OR DRINK FOR 6-HOURS PRIOR TO THE SCHEDULED TIME OF YOUR INJECTION
  • HOLD ASPIRIN FOR 7 DAYS AND HOLD NSAID’S (Naproxen, Ibuprofen) FOR 3 DAYS PRIOR TO INJECTION.
  • FOR BLOOD THINNERS (Coumadin, Heparin, Plavix) SPEAK TO YOUR DOCTOR FOR SPECIFIC INSTRUCTIONS.

Patient Instructions:

  • No driving for the rest of the day.
  • Apply ice to the area every 15 minutes as needed.
  • Continue exercises and stretches as before and as tolerated by pain.
  • Drink extra fluids for the next 24 hours.
  • Take pain medication if needed as prescribed.
  • Monitor your level of pain or pain relief from the time the injection is completed.
  • Guard the affected area if numbness is present.
  • Follow up as directed
  • IF YOU HAVE PROBLEMS CALL 303-788-9322 OR 303-423-8334

 

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