Name of the Procedure:

Epidural or Subarachnoid Injection (Lumbar or Sacral) Common name: Spinal Injection
Medical term: Interlaminar Epidural or Subarachnoid Injection

Summary

An epidural or subarachnoid injection involves delivering therapeutic or diagnostic substances into the lower spine using a needle or catheter. This procedure can help manage pain or treat various spinal conditions.

Purpose

This procedure addresses lower back pain, sciatica, or other spinal conditions. It aims to alleviate pain, reduce inflammation, or provide diagnostic information about spine-related issues.

Indications

• Persistent lower back pain
• Sciatica or leg pain
• Spinal stenosis
• Herniated disc
• Chronic pain conditions
• Patients who have not responded to conservative treatments

Preparation

• Fast for at least 6-8 hours prior to the procedure.
• Adjust medications as directed by the healthcare provider (especially blood thinners).
• Inform the doctor of any allergies or existing medical conditions.
• Complete any required blood tests or imaging studies.

Procedure Description

1. The patient lies face-down on a procedure table.
2. The skin over the lumbar or sacral spine is cleaned and sterilized.
3. Local anesthesia may be applied to numb the injection site.
4. Using fluoroscopic (X-ray) guidance, a needle or catheter is carefully inserted into the epidural or subarachnoid space.
5. The diagnostic or therapeutic substance, such as an anesthetic, steroid, or other solution, is injected.
6. The needle or catheter is removed, and a bandage is applied.

Duration

The procedure typically takes about 15-30 minutes.

Setting

Performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Anesthesiologist or Pain Specialist (performs the injection)
• Nurse (assists and monitors the patient)
• Radiology Technician (assists with imaging guidance)

Risks and Complications

• Common: Discomfort at the injection site, temporary numbness or weakness.
• Rare: Infection, bleeding, nerve damage, headache, allergic reactions.
• Management: Immediate treatment for any adverse effects, follow-up care if complications occur.

Benefits

• Pain relief can be immediate or develop over several days.
• Reduced inflammation and improved mobility.
• Helps identify the source of pain for further treatment.

Recovery

• Rest for the remainder of the day following the procedure.
• Avoid strenuous activities for a few days.
• Follow any specific instructions from the healthcare provider.
• Schedule and attend follow-up appointments as needed.

Alternatives

• Physical therapy
• Oral pain medications
• Nerve blocks
• Surgery (in severe cases)
• Pros and cons vary based on individual cases and should be discussed with a healthcare provider.

Patient Experience

• Some discomfort or pressure felt during the injection.
• Local anesthesia minimizes pain during the procedure.
• Potential soreness or mild discomfort at the injection site for a day or two post-procedure.
• Pain relief and improvement in symptoms can be felt immediately or within a few days.