Name of the Procedure:

Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar. Commonly referred to as "Interlaminar Epidural Injection."

Summary

An interlaminar epidural injection involves placing a catheter in the epidural space of the spine to deliver diagnostic or therapeutic drugs. This procedure helps manage pain or diagnose certain conditions by injecting medications like anesthetics, steroids, or opioids directly around the spine.

Purpose

• Medical Condition/Problem It Addresses: Chronic or acute pain, inflammation, and muscle spasticity.
• Goals/Expected Outcomes: Relief from pain, reduction in inflammation, improved mobility, and an accurate diagnosis of the underlying condition.

Indications

• Severe back or neck pain
• Sciatica or radiculopathy (nerve pain radiating from the spine)
• Herniated discs
• Spinal stenosis
• Inflammation or muscle spasticity
• Patients who have not responded to conservative treatments like oral medications or physical therapy

Preparation

• Pre-Procedure Instructions:
  • Fasting for several hours before the procedure
  • Stopping certain medications (e.g., blood thinners) as advised by the doctor
• Diagnostic Tests/Assessments:
  • MRI or CT scan to identify the affected area
  • Physical examination and medical history review

Procedure Description

1. Positioning: The patient lies face down on a procedure table.
2. Anesthesia: Local anesthetic applied to numb the area where the injection will be given.
3. Catheter Placement: A needle is inserted into the interlaminar space of the spine, guided by fluoroscopy (live X-ray).
4. Injection: A catheter is threaded through the needle, and medications are administered either continuously or in intermittent doses.
5. Monitoring: The patient is monitored for any immediate reactions.

• Tools/Equipment: Needle, catheter, fluoroscopy machine
• Anesthesia/Sedation: Local anesthesia, with sedation options if necessary

Duration

Typically takes about 30 to 60 minutes.

Setting

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

Personnel

• Pain management specialist or anesthesiologist
• Nurse or medical assistant
• Radiology technician for fluoroscopy

Risks and Complications

• Common risks: Pain at the injection site, headache, temporary numbness
• Rare risks: Infection, bleeding, nerve injury, allergic reaction to the medication
• Management: Immediate medical attention and medication for adverse effects

Benefits

• Pain relief typically felt within a few days to a week
• Reduction in inflammation and muscle spasticity
• Improved mobility and quality of life

Recovery

• Post-Procedure Care: Rest for a few hours, apply ice packs if needed
• Expected Recovery Time: Generally a few days
• Restrictions/Follow-Up: Avoid strenuous activity for a day or two, follow up with the doctor for reassessment

Alternatives

• Oral pain medications
• Physical therapy
• Surgical options like spinal fusion or laminectomy
• Pros and cons: Non-invasive options may not be as effective; surgery carries its own risks

Patient Experience

• During the Procedure: Mild discomfort or pressure during catheter placement
• After the Procedure: Possible soreness at the injection site; pain relief usually noticed within a few days
• Pain Management/Comfort Measures: Local anesthetics and over-the-counter pain relievers as needed