Lumbar Epidural Steroid Injection

Anatomy

The epidural space is an area immediately outside of a protective sac (the dura) which contains the spinal cord. Spinal nerves emerge through the sides of the epidural space after coming off the spinal cord. In the low back these spinal nerves supply the back and legs.

Spinal nerves commonly become inflamed near their exit from the spine. It is at these exit points, or neuroforamen, that nerves may become "pinched" secondary to a herniated disc, bone spurs, calcification, or a narrowed disc space. Pressure on spinal nerves in the low back causes localized back pain, pain radiating into a leg (sciatica), numbness or weakness of a leg.

What is an epidural steroid (cortisone) injection? Why is it helpful?

An epidural steroid injection is the injection of cortisone and local anesthetic into the epidural space. The purpose of the injection is to reduce nerve inflammation. By reducing inflammation, symptoms of pain, numbness, and weakness may improve. The duration of pain relief is variable depending upon the severity of the condition and the body's ability to heal itself. Many times the injections will be done in a series of up to three- each one to two weeks apart- to help break the pain cycle.

What will happen to me during the procedure?

An IV will be started so that relaxation medication can be given. You will be taken to a procedure room and positioned on your stomach. Monitors will be placed on you to watch your heart rate, blood pressure, and blood oxygen level.

The skin on your back will be washed with a sterile scrub (soap) then numbed with local anesthetic. Your physician will insert a special needle into the epidural space using fluoroscopy to guide needle placement. A small amount of contrast dye will then be injected to confirm placement of medication into the epidural space. Finally, the doctor will inject a mixture of local anesthetic (numbing) medication and cortisone (anti-inflammatory) into the epidural space.

What will happen after the procedure?

You will be taken back to the recovery area and monitored for 30-60 minutes. You may experience numbness or weakness in the buttock and legs for a short period of time after the procedure. Discharge instructions will be given to you before leaving the surgical center.

Due to the use of relaxation medications, you are required to have a driver to take you home.

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