Lumbar Transforaminal Epidural Steroid Injections

Lumbar transformanial epidural steroid injections are performed to relieve low back and radiating leg pain.

The steroid medication can reduce the swelling and inflammation caused by spinal conditions such as spinal stenosis, radiculopathy, sciatica, and herniated discs. The patient lies face down. A cushion is placed under the stomach area to provide comfort and to flex the back.

This position causes the spine to pull allowing for easier access to the epidural space. The physician uses a fluoroscope to locate the appropriate lumbar vertebra and nerve root and a local anesthetic numbs the skin. All of the tissue down to the surface of the vertebral transverse process is anesthetized. The physician slides a thin bent needle with a slightly curved point through the anesthetized track.

With the aid of a flouroscope, the physician carefully guides the needle into the foraminal space near the nerve root. The physician injects a contrast solution and uses the fluoroscope to see the painful areas and confirm the correct location of the needle tip. A steroid anesthetic mix is injected into the foraminal epidural space bathing the painful nerve root with soothing medication. the needle is removed and a small band aid is used to cover the tiny needle surface wound. In some cases, it may be necessary to repeat the procedure as much as 3 times to provide the full benefit of the medication. However, many patients feel significant relief after only one or two injections.

Additional pain management options my be extremely beneficial in conjunction with epidural injections. These may include physical therapy, chiropractic, spinal decompression, and pain medications.