Name of the Procedure:

Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level

Summary

This minimally invasive procedure involves injecting an anesthetic or steroid medication into the epidural space around the spinal nerves in the cervical (neck) or thoracic (upper back) region. Imaging guidance using fluoroscopy (live X-ray) or CT scan ensures accurate placement of the needle.

Purpose

The procedure aims to relieve pain and inflammation caused by conditions such as herniated discs, spinal stenosis, or nerve root compression in the cervical or thoracic spine.

Indications

• Persistent neck or upper back pain not responding to conservative treatments.
• Radicular pain (pain radiating from the spine to the limbs).
• Diagnostic purposes to identify the pain source.
• Candidates typically have symptoms like numbness, tingling, or weakness in the limbs.

Preparation

• Patients may need to fast for several hours before the procedure.
• Medications, especially blood thinners, may need to be adjusted or paused.
• Pre-procedure imaging and blood tests may be required to confirm suitability.

Procedure Description

1. Patient lies on their stomach or side.
2. Local anesthesia is applied to numb the injection site.
3. Using fluoroscopy or CT imaging, a needle is carefully inserted into the epidural space at the targeted spinal level.
4. An anesthetic and/or steroid medication is injected.
5. The needle is removed, and the injection site is covered.

Duration

The procedure typically takes about 30 minutes to 1 hour.

Setting

Performed in a hospital's radiology department, outpatient clinic, or a surgical center.

Personnel

• Interventional radiologist or pain management specialist.
• Radiology technician.
• Nursing staff.

Risks and Complications

• Common risks: Pain at injection site, temporary increase in pain, headache.
• Rare risks: Infection, bleeding, nerve damage, allergic reaction.
• Complications are managed with medications, rest, or additional interventions if necessary.

Benefits

• Pain relief can be immediate or develop over a few days.
• Reduction in inflammation and improved mobility.
• Potential to avoid or delay surgical options.

Recovery

• Post-procedure rest for a few hours.
• Resume normal activities gradually.
• Instructions on pain management, use of ice packs, and any activity restrictions.
• Follow-up appointment to assess effectiveness and plan further treatment if needed.

Alternatives

• Oral medications (pain relievers, anti-inflammatories).
• Physical therapy.
• Other types of injections (facet joint injections, medial branch blocks).
• Surgical options in severe cases.
• Each alternative has its own set of benefits and risks compared to the transforaminal epidural injection.

Patient Experience

• Slight pressure or discomfort during needle insertion.
• Immediate relief may be felt, or it may take a few days.
• Post-procedure soreness manageable with over-the-counter pain relievers.
• Advised to rest and avoid strenuous activities for a short period.