LUMBAR TRANSFORAMINAL EPIDURAL STEROID INJECTION

People suffering from acute or chronic pain in the lower back and/or legs can benefit from this kind of procedure, and there are multiple types of conditions that can cause this kind of pain. A transforaminal injection is an injection of a long-acting steroid into the opening at the side of the spine where a nerve root exits. This opening is known as a foramen. There is a small sleeve of the epidural space that extends out over the nerve root for a short distance. This epidural root sleeve is just outside the spinal canal. Sometimes these injections are referred to as root sleeve blocks, root blocks or transforaminal epidural blocks. The long-acting steroid that is injected reduces the inflammation and swelling of spinal nerve roots and other tissues surrounding the spinal nerve root. This, in turn, may reduce pain, tingling and numbness and other symptoms caused by such inflammation, irritation or swelling. Also, the transforaminal injections can be used to identify a specific spinal nerve root level or levels that are the source of pain.

Running along the spine are dozens of nerves that branch out to every part of the body, and if these nerves become inflamed, irritated or pinched, painful symptoms can develop in the area of the body connected to the affected nerve. These are the areas where a lumbar transforaminal epidural steroid injection can help ease the pain. Sciatica is the name for the type of pain associated with this region, and it is often the result of the cumulative effect of years of bad posture, obesity, and natural wear and tear as we age. Also, it can suddenly occur due to an injury or other trauma.

There are several other conditions that can be treated with lumbar transforaminal epidural steroid injections. These include:

• Lumbar Disc Herniation
• Degenerative Disc Disease
• Lumbar Spinal Stenosis
• Compression Fractures in a Vertebra
• Synovial Cyst in the Lumbar Spine
• Lumbar Annular Tear

A transforaminal injection involves the administration of a long-acting steroid medication into the opening at the side of the spine where a nerve root exists and is causing pain. It is done either with the patient on the side for most neck injections and with the patient on the stomach for back injections. Occasionally other positions are used to optimize the X-ray view. All patients receiving sedation are monitored with EKG, blood pressure cuff and oxygen monitoring device. Patients not receiving sedation are monitored if needed. The skin of the neck or back is cleaned with antiseptic solution and sometimes numbed with local anesthetic. Then the injection needle is placed under X-ray guidance. Once in place, the injection is made and this will often feel like the normal pain that the patient feels in the distribution of that particular spinal nerve root. Finally, the needle is removed and an adhesive bandage is applied. This technique is useful for delivering a more concentrated dose of the steroid into a specific area. Transforaminal epidural steroid injections can provide both diagnostic and therapeutic benefits.

An immediate effect of numbness usually from the local anesthetic injected. This wears off in a few hours. The patient will be monitored for a short period of time before being discharged to go home. Benefits of the procedure are usually noticed within the first few hours after the procedure, but the steroid fully starts working in about 3 to 5 days and its effect can last for several days to several months. Additional injections may be needed later depending on the individual. A series of up to 3 more injections may be recommended, and when combined with physical therapy, this non-surgical treatment approach can be very effective for long-term spine-related pain relief.