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, Lumbar or Sacral

Summary

This procedure involves delivering a diagnostic or therapeutic substance into the epidural or subarachnoid space of the lumbar or sacral spine using a needle or catheter. It aims to provide pain relief, reduce inflammation, or diagnose the source of back pain.

Purpose

This procedure addresses conditions like chronic back pain, sciatica, or radiculopathy. The goal is to relieve pain, reduce inflammation, or diagnose the source of symptoms by observing the body's response to the injected substances.

Indications

• Chronic lower back pain
• Sciatica
• Radiculopathy (pain radiating from the spine to the legs)
• Spinal stenosis
• Disc herniation

Patients who have not responded to conservative treatments like physical therapy or medication may be considered appropriate candidates.

Preparation

• Patients may be instructed to fast for a few hours prior to the procedure.
• Certain medications may need to be adjusted or paused.
• Pre-procedure imaging tests (like MRI or CT scans) might be performed to precisely locate the injection site.

Procedure Description

1. The patient is positioned face down or in a seated, curled position.
2. The skin over the injection site is sterilized.
3. A local anesthetic may be applied to numb the area.
4. Using fluoroscopic (X-ray) or ultrasound guidance, a needle or catheter is inserted into the epidural or subarachnoid space.
5. The diagnostic or therapeutic substance (such as an anesthetic, steroid, or opioid) is injected.
6. The needle or catheter is carefully removed, and a bandage is applied to the injection site.

Duration

The procedure typically takes between 30 minutes to 1 hour.

Setting

• Hospital
• Outpatient clinic
• Surgical center

Personnel

• Interventional radiologist or anesthesiologist
• Nurses
• Radiology technicians

Risks and Complications

Common risks:

• Temporary discomfort at the injection site
• Headache

Rare complications:

• Bleeding
• Infection
• Nerve damage
• Allergic reactions to the injected substance

These complications can typically be managed with additional medical treatments if they arise.

Benefits

• Immediate and significant pain relief
• Reduction in inflammation
• Improved mobility and quality of life
• Diagnostic clarity for subsequent treatment plans

Recovery

• Patients are usually observed for a short period post-procedure.
• Most can return to normal activities within a day.
• Instructions may include avoiding strenuous activities for a few days.
• Follow-up appointments might be scheduled to monitor response to treatment.

Alternatives

• Oral or topical medications
• Physical therapy
• Chiropractic care
• Surgery (in severe cases)

Each option has its pros (non-invasive, long-term relief) and cons (delayed effect, potential side effects), and the best choice depends on the individual patient's condition and response to treatments.

Patient Experience

During the procedure, the patient may feel pressure or mild discomfort at the injection site. Post-procedure, some mild soreness can be expected, but pain management strategies are in place to ensure comfort. Most patients report significant pain relief shortly after the procedure.