Epidural steroid injection (ESI) is modern technique in which corticosteroids and a local anesthetic are injected into the epidural space around the spinal cord in an effort to improve spinal stenosis, spinal disc herniation, or both. An epidural injection provides temporary or prolonged relief from pain or inflammation in the spine or extremities. Imaging guidance may be used to place the needle in the right location for maximum benefit. The injection may also help confirm the exact site of the pain generator.
The epidural injection usually takes only minutes to administer. Elective spinal injections is performed with imaging guidance, such as fluoroscopy or the use of a radiocontrast agent, unless that guidance is contraindicated. Imaging guidance ensures the correct placement of the needle and maximizes the physician’s ability to make an accurate diagnosis and administer effective therapy.
Without imaging, the risk increases for the injection to be incorrectly placed and this would in turn lower the therapy’s efficacy and increase subsequent risk of need for more treatment. While traditional techniques without image guidance, also known as blind injections, can assure a degree of accuracy using anatomical landmarks, As per the research and studies by experts shown that , Image guidance technology provides much more reliable localization and accuracy in comparison with Blind injection.
The surgeon place an intravenous (IV) line in your arm to deliver a relaxation medication during the procedure; this is seldom needed but will be available if required. You will be advised to sit on your stomach or on your side, on a table in the fluoroscopic room or in computed tomography room and made to feel as comfortable as possible.
The doctor will identify where the injection should be given and will clean and sterilize the skin with an antiseptic solution. Then inject a local anesthetic to help numb the area before administering the epidural injection.
Once the area is numb, the doctor will most likely use imaging guidance to help guide the epidural needle to exactly the right position. When the needle is in place, a contrast material will be injected so the doctor can accurately target the nerves for sufficient distribution of the medication. Then, doctor will slowly inject the medication, which is typically a combination of anesthetic and anti-inflammatory drugs (cortisone/steroids).
When finished, you will be moved into a chair or bed and allowed to rest for a few minutes to an hour. The surgeons will make sure you do not have any unfavorable reactions to the medication before you are allowed to leave.