Lumbar Interlaminar & Transforaminal Epidural Injection
Chronic lower back pain is a common complaint among patients with conditions which include, but are not limited to lumbar radiculopathy, lumbar stenosis, herniated disc or disc bulge, degenerative disc disease, osteoarthritis, failed surgery, and those who failed to qualify as surgical candidates. Additionally lower back pain is often associated with other symptoms such as the radiation of pain down the lower extremities as well as perhaps tingling, weakness, numbness, or paraesthesias. However, this chronic pain and its associated symptoms can be treated with excellent precision & efficacy through the introduction of anesthetic medications and steroids into the epidural space around spinal nerve roots to help reduce inflammation and pain. Therefore our clinic offers a procedure known as Lumbar Interlaminar & Transforaminal Epidural Injection: a short 10-15 minute procedure where we can effectively target the epidural space with our injectable anesthetic and steroid medications which can thereby substantially reduce the pain of those suffering from chronic lower back pain with associated symptoms. Please note that the difference between interlaminar and transforaminal is merely the approach of technique with interlaminar typically being a midline procedure between the spinous process & adjacent vertebrae while the transforaminal technique is a lateral or angled approach.
You will arrive at our clinic 15 minutes prior to your appointment with a designated driver where we will educate you at length on the benefits & risks of the procedure. After this discussion we will then have you sign a consent form and you will subsequently be positioned in preparation for the procedure.
Chloraprep will then be used to clean the procedural site & surrounding skin to help decrease chances of infection. The procedure site will then be identified under fluoroscopic guidance. Once the site is appropriately identified an injection of a numbing medication called lidocaine will be administered to numb the procedural site & surrounding skin. Then a loss of resistance syringe will be used to assess the epidural space and an injection of a contrast agent (omnipaque) to visualize the epidural space under fluoroscopic guidance. Following this clinical assessment and once the lidocaine has settled the targeted epidural space will be injected with a cocktail consisting of anesthetic (bupivacaine), steroid (dexamethasone), and normal saline solution. This cocktail disperses and bathes the spinal nerve roots and nerves providing optimal pain relief with most of our patients reporting significant relief at post-procedural follow up of 2 weeks. Following procedure you will then be assessed and observed for an additional 5-10 minutes following completion of the procedure to ensure your safety and then scheduled for post-procedural follow up by our staff.
● Substantial reduction in lower back pain and associated radicular symptoms
● Pain relief ranging from days to as long as 3-12 months or greater
● Acute short term mild swelling or pain around the injection site
Risks Associated With Lumbar Interlaminar & Transforaminal Epidural Injection
● Misplacement of the needle
● Spinal headaches
● Unexpected bleeding
● Drug allergies
● Infection
● Nerve damage
● Worsening pain
