Name of the Procedure:

Interlaminar Epidural Injection with Indwelling Catheter for Continuous or Intermittent Infusion

Summary

This procedure involves placing a catheter in the interlaminar space of the spine to administer a continuous infusion or intermittent bolus of diagnostic or therapeutic substances. It aims to alleviate pain or treat other conditions without the use of neurolytic substances.

Purpose

• Medical Conditions Addressed: Chronic pain, inflammation, muscle spasms, and other spinal-related issues.
• Goals: To provide pain relief, reduce inflammation, manage spasms, or deliver medications directly to the affected area.

Indications

• Persistent or chronic spinal pain.
• Inflammatory conditions affecting the spine.
• Muscle spasms or severe muscle tightness.
• Patients who have not responded well to oral medications or other treatments.

Preparation

• Pre-Procedure Instructions: Fasting for a few hours before the procedure; discontinue certain blood-thinning medications as advised.
• Diagnostic Tests: MRI or CT scans to identify the exact location and extent of the issue.

Procedure Description

1. Step 1: The patient is positioned to allow easy access to the spine.
2. Step 2: A local anesthetic is administered to numb the injection site.
3. Step 3: An interlaminar needle is inserted into the spine’s epidural space.
4. Step 4: A catheter is threaded through the needle into the epidural space.
5. Step 5: The therapeutic or diagnostic substance is infused through the catheter, either continuously or in boluses.
6. Step 6: The catheter is secured in place for ongoing treatment as needed.

• Tools Used: Interlaminar needle, catheter, infusion pump.
• Anesthesia: Local anesthesia is typically used.

Duration

The procedure itself usually takes about 30 to 60 minutes.

Setting

Typically performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Anesthesiologist or Pain Specialist
• Nurse
• Radiologic Technologist (if imaging is used)

Risks and Complications

• Common Risks: Minor bleeding, infection at the injection site, temporary pain at the injection site.
• Rare Complications: Nerve damage, severe infection, allergic reaction to the administered substances.

Benefits

• Expected Benefits: Pain relief, reduced inflammation, improved mobility.
• Timeline for Benefits: Benefits may be seen within a few hours to a few days after the procedure.

Recovery

• Post-Procedure Care: Monitor the injection site for signs of infection; limit strenuous activities for a few days.
• Recovery Time: Most patients can return to their normal activities within 24-48 hours.
• Follow-Up: Regular follow-up appointments to monitor the effectiveness and adjust treatment as necessary.

Alternatives

• Other Treatment Options: Oral medications, physical therapy, nerve blocks, or surgery.
• Pros and Cons of Alternatives: Oral medications may have systemic side effects; physical therapy requires longer commitment; surgery carries higher risks but may provide more permanent relief.

Patient Experience

• During the Procedure: You may feel pressure or mild discomfort.
• After the Procedure: Mild soreness at the injection site; improved relief from symptoms.
• Pain Management: Pain is typically managed with local anesthesia during the procedure and over-the-counter pain relief if needed afterward.