Name of the Procedure:

Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with ultrasound guidance, lumbar or sacral; single level.

Summary

This procedure involves injecting an anesthetic agent and/or steroid medication into the epidural space of the lumbar or sacral spine. The injection is performed using ultrasound guidance to ensure accurate placement of the needle at a single spinal level.

Purpose

This procedure is designed to relieve pain and inflammation in the lower back or legs that is caused by nerve root irritation or compression. The primary goal is to reduce pain, improve mobility, and enhance the quality of life.

Indications

• Chronic lower back pain
• Sciatica or radiculopathy
• Herniated disc
• Spinal stenosis
• Degenerative disc disease
• Pain unresponsive to conservative treatments (e.g., physical therapy, medications)

Preparation

• Follow fasting instructions, usually no eating or drinking for 6-8 hours before the procedure.
• Adjust or stop certain medications as instructed by your healthcare provider (e.g., blood thinners).
• Undergo necessary diagnostic tests like MRI or CT scans to locate the pain source.
• Arrange for someone to drive you home after the procedure.

Procedure Description

1. The patient lies face down on a procedure table.
2. The skin over the lumbar or sacral area is cleaned and sterilized.
3. Local anesthesia is administered to numb the injection site.
4. Ultrasound guidance is used to visualize the precise location for needle insertion.
5. A needle is carefully inserted into the epidural space near the affected nerve root.
6. An anesthetic agent and/or steroid medication is injected.
7. The needle is removed, and a sterile bandage is applied.

Duration

The procedure typically takes about 30-60 minutes, including preparation and recovery time.

Setting

The procedure is usually performed in an outpatient clinic, surgical center, or hospital.

Personnel

• Interventional radiologist or pain management specialist
• Nurse or medical assistant
• Anesthesiologist (if sedation is required)

Risks and Complications

• Common: Temporary pain at the injection site, headaches, dizziness
• Rare: Infection, bleeding, nerve damage, allergic reactions to medications
• Blood pressure fluctuations and transient numbness or weakness may occur

Benefits

• Reduction in pain and inflammation
• Improved mobility and function
• Quicker return to daily activities
• Potential to delay or avoid surgical interventions
• Pain relief may be felt within a few days to a week and can last for several weeks to months

Recovery

• Rest for the remainder of the day following the procedure
• Avoid strenuous activities for 24-48 hours
• Follow-up appointment to assess effectiveness and discuss further treatment
• Gradual return to normal activities as pain improves

Alternatives

• Physical therapy
• Oral pain medications
• Nerve blocks
• Radiofrequency ablation
• Spinal cord stimulation
• Surgical interventions (e.g., discectomy, laminectomy)

Patient Experience

During the procedure, the patient might feel mild discomfort or pressure when the needle is inserted. Post-procedure, some patients experience temporary soreness at the injection site. Pain relief may take a few days to manifest. Pain management and comfort measures are provided throughout the process to ensure patient comfort.