Name of the Procedure:

Epidurography, Radiological Supervision, and Interpretation

Summary

Epidurography is a diagnostic imaging procedure that involves injecting contrast dye into the epidural space of the spine and then taking X-ray images. This helps doctors assess the spinal cord, nerve roots, and surrounding structures to diagnose conditions related to the spine.

Purpose

Epidurography is used to identify abnormalities in the spinal cord or nerve roots, such as herniated discs, spinal stenosis, or spinal injuries. The goal is to provide a clear image for accurate diagnosis and to guide subsequent treatment plans.

Indications

• Persistent back pain not relieved by conservative treatment
• Radiating pain down the legs (sciatica)
• Suspected herniated discs or spinal stenosis
• Post-surgical assessment
• To plan for further spinal procedures or surgeries

Preparation

• Patients may need to fast for several hours before the procedure.
• Medication adjustments, such as stopping blood thinners, may be necessary.
• Pre-procedure diagnostic tests like MRI or CT scans may be required.
• Patients should arrange for someone to drive them home post-procedure.

Procedure Description

1. The patient lies face down on an X-ray table.
2. The skin over the injection site is cleaned and numbed with a local anesthetic.
3. Using fluoroscopy (real-time X-ray guidance), a needle is inserted into the epidural space.
4. Contrast dye is injected through the needle.
5. X-ray images are taken to visualize the distribution of the dye and the structure of the spine.
6. The needle is removed, and the injection site is bandaged.

Duration

The entire procedure typically takes about 30 to 60 minutes.

Setting

Epidurography is usually performed in a hospital radiology department or an outpatient imaging center.

Personnel

• Radiologist or Interventional Pain Specialist
• Radiologic Technologist
• Nurse or Medical Assistant

Risks and Complications

• Common: Temporary discomfort at the injection site, headache
• Rare: Infection, bleeding, allergic reaction to contrast dye, nerve damage
• Complications can be managed with appropriate medical intervention.

Benefits

• Accurate diagnosis of spinal conditions
• Improved planning for further treatment or surgery
• Symptom relief if therapeutic measures are combined with diagnostic

Recovery

• Patients may experience soreness at the injection site for a few days.
• Most can return to normal activities the following day, but heavy lifting and strenuous activities should be avoided for a few days.
• Follow-up appointments may be scheduled to discuss results and next steps.

Alternatives

• MRI or CT scan without contrast: Non-invasive but may not provide as detailed information.
• Myelography: Another type of contrast imaging of the spinal cord, but more invasive.
• Conservative treatments: Physical therapy, medications, and epidural steroid injections.

Patient Experience

• The injection may cause brief discomfort, but the area will be numbed.
• The patient may feel pressure as the needle is inserted.
• Post-procedure, some soreness is expected, but pain management measures will be provided as needed. Comfort measures such as applying ice packs to the injection site may also help with recovery.