Name of the Procedure:

Injection(s) of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic.

Summary

This procedure involves the injection of medication into the epidural or subarachnoid space in the cervical or thoracic spine. It can be used for both diagnostic and therapeutic purposes, typically to relieve pain or diagnose the source of spinal issues.

Purpose

This procedure addresses conditions such as chronic pain, inflammation, or muscle spasms in the cervical or thoracic region of the spine. The goal is to provide pain relief and to improve the patient's quality of life.

Indications

• Chronic neck or upper back pain
• Nerve pain (radiculopathy) in the cervical or thoracic spine
• Inflammation of the spinal joints or nerves
• Diagnostic purposes to identify the specific source of pain

Preparation

• Patients may need to fast for a few hours before the procedure.
• Adjustment of current medications, especially blood thinners, might be necessary.
• Diagnostic tests such as MRI or CT scans may be required beforehand.

Procedure Description

1. The patient is positioned comfortably, usually lying on their stomach.
2. The skin over the injection site is cleaned and sterilized.
3. Local anesthesia is applied to numb the area.
4. Using X-ray or fluoroscopic guidance, a needle or catheter is inserted into the epidural or subarachnoid space.
5. The therapeutic or diagnostic substance is injected.
6. The needle or catheter is removed, and a small bandage is applied.

Tools and equipment: X-ray or fluoroscopy machine, sterile needles, catheters, local anesthetics, and the specific diagnostic or therapeutic substances.

Duration

The procedure typically takes about 15 to 30 minutes.

Setting

This procedure is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Interventional radiologist or anesthesiologist
• Radiology technician
• Nursing staff

Risks and Complications

• Common: Temporary pain at the injection site, headaches, dizziness
• Rare: Infection, bleeding, nerve damage, allergic reactions
• Management of complications may include medications or further medical interventions.

Benefits

• Pain relief, often within a few days to a week
• Improved mobility and function
• Potentially reduced need for oral pain medications

Recovery

• Rest for the remainder of the day after the procedure
• Avoid heavy lifting and strenuous activities for at least 24 hours
• Follow-up appointments to monitor the response to treatment and adjust as necessary

Alternatives

• Oral medications (analgesics, anti-inflammatories)
• Physical therapy
• Alternative procedures (nerve blocks, radiofrequency ablation, surgical options)
• Pros and cons vary based on the patient’s specific condition and overall health.

Patient Experience

During the procedure, the patient may feel mild discomfort or pressure at the injection site. Pain management measures, including local anesthetics and post-procedure medications, are employed to ensure comfort. After the procedure, some patients may experience temporary tenderness at the injection site and will typically be advised to rest and avoid strenuous activities for a short period.