Name of the Procedure:

Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level

Summary

This procedure involves injecting anesthetic agents and/or steroids into the epidural space of the lumbar or sacral spine using imaging guidance. It targets multiple levels of the spine to help relieve pain and inflammation.

Purpose

• Medical Condition: This procedure is commonly used to treat conditions like herniated discs, sciatica, spinal stenosis, and other sources of chronic pain and inflammation in the lower back and legs.
• Goals: The primary goals are to reduce inflammation, alleviate pain, and improve functionality.

Indications

• Persistent lower back pain or leg pain that does not respond to conservative treatments (physical therapy, medications).
• Radiculopathy or nerve pain stemming from spinal issues.
• Candidates are typically those who experience significant pain that interferes with daily activities.

Preparation

• Patients may be advised to fast for a few hours before the procedure.
• Medication adjustments might be necessary, especially for blood thinners.
• Pre-procedure imaging tests like MRI or CT scans may be conducted to locate the exact area for injection.

Procedure Description

1. The patient is positioned on the procedure table.
2. Fluoroscopy or CT imaging is used to guide needle placement.
3. The skin is cleaned and numbed with a local anesthetic.
4. A needle is carefully inserted into the transforaminal epidural space.
5. Contrast dye may be injected to confirm the correct placement.
6. After confirmation, the anesthetic and/or steroid is injected.
7. The process is repeated for each additional spinal level as required.

Duration

The procedure typically takes about 30 to 60 minutes, depending on the number of levels treated.

Setting

This procedure is usually performed in a hospital, outpatient clinic, or surgical center equipped with the necessary imaging technology.

Personnel

• Interventional radiologist or spine specialist (performs the injection).
• Radiologic technologist (operates imaging equipment).
• Nurse or medical assistant (provides support and monitors the patient).

Risks and Complications

• Common risks include localized pain, temporary numbness, or weakness.
• Rare but possible complications include infection, bleeding, nerve damage, or allergic reactions to the contrast dye or medications.

Benefits

• Reduced inflammation and pain, often noticeable within a few days to a week.
• Improved ability to perform daily activities.
• Potentially longer-term pain relief compared to other conservative treatments.

Recovery

• Patients are usually monitored for a short time after the procedure and can often go home the same day.
• Post-procedure instructions may include avoiding strenuous activities for a short period.
• Follow-up appointments are important to assess the effectiveness and discuss ongoing treatment plans.

Alternatives

• Physical therapy and medications.
• Other types of spinal injections like facet joint injections or caudal epidural injections.
• Surgical options, which might be considered if conservative treatments fail.

Patient Experience

• During the procedure, patients may feel pressure or minor discomfort at the injection site.
• Post-procedure soreness is common but usually subsides quickly.
• Pain management strategies, including medications or ice packs, may be recommended to enhance comfort.