Cervical Epidural Steroid Injection What is the epidural space? The membrane that covers the spine and nerve roots in the neck is called the dura membrane. The space surrounding the dura is the epidural space. Nerves travel through the epidural space to the neck, shoulder and arms. Inflammation of these nerve roots may cause pain in these regions due to irritation from a damaged disc or from contract with the bony structure of the spine in some way. What is an epidural and why is it helpful? An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing the pain in the neck, shoulders and arms. The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief for several months while the injury/cause of pain is healing. What happens during the procedure? The procedure is carried out by trained pain specialist under an aseptic technique.An IV is started so that relaxation medication can be given. The patient is placed prone and positioned in such a way that the physician can best visualize the neck using x-ray guidance. The skin on the back of the neck is cleaned with an antiseptic solution.Next, the physician numbs a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a Touhy needle very carefully using x-ray guidance into epidural space. A small amount of contrast (dye) is injected to insure the needle is properly positioned in the epidural space. This is called a cervical epidurogram.Then, a small mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steroid) is injected. What happens after the procedure? Patients are then returned to the recovery area where they are monitored for 30-60 minutes. Patients are then asked to record the relief they experience during the next week on a post injection evaluation sheet ("pain "diary"). A cervical epidural steroid may provide symptomatic pain relief from anywhere between few weeks upto 6 months or even longer.The pain specialist may repeat the procedure if necessary but usually not more than three times in a year. Cervical epidural steroid can produce dramatic relief to patients suffering from pinched nerve at the neck with pain radiating down the arms.Further more the procedure itself is much safer than surgery and done as a day case. General pre/post instructions Patients can eat a light meal within a few hours before the procedure. If a patient is a diabetic, they must not change their normal eating pattern prior to the procedure and they must let the doctor know of the medications they are on especially blood thinning medications like Warfarin/plavix which is a contraindications to performing this procedure. Please consult a pain specialist for further information.
Posted on: Tue, 30 Jul 2013 13:31:08 +0000
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