Spinal Injections Treatment
Epidural
An epidural injection is an injection of a particular medication into the epidural space (space surrounding the spinal cord). The epidural space is the outmost layer of the spinal canal. The medications typically used for an epidural injection consist of anaesthetics, steroids, and anti- inflammatory drugs. The aim of the procedure is to reduce pain and inflammation surrounding the spinal nerve roots in order to give the damaged nerves time to heal. Computer Tomography (CT) is used as the image guiding modality of choice so the doctor can target the exact location that is causing the pain.
Spinal injections are an alternative treatment for patients who are suffering pain and not responding to conservative treatments. Indications for epidural injections include a herniated or bulging disk, spinal stenosis, postoperative “failed back” surgery syndrome, bone spurs or other injures to spinal nerves, vertebrae and surrounding tissues.
Preparation
If you are taking any anticoagulants (blood thinners) we ask that you cease taking these for 5 days (Aspirin, Plavix, clopidogrel, heparin) prior to your scheduled appointment. If you are taking warfarin (Coumadin) we require a normal INR laboratory test in order to conduct the injection.
You will also need a friend or someone close to drive you home after the procedure.
The Procedure
The CT machine is used to help the doctor place the needle in the correct position. The CT machine is often described as donut shaped. You will be positioned on the examination table either on your stomach or side. The doctor will identify where the injection will be administered and will clean the area with antiseptic solution. Local anaesthetic will be injected to numb the area before commencement of the injection. Once the local anaesthetic has sufficiently numbed the area the needle will be placed in the correct position following use of CT image guidance. Contrast dye will be injected to confirm positioning to accurately target the nerves for sufficient distribution of the medication. Commencement of the injection containing the medication will then begin.
The injection should only take a couple of minutes the majority of the time is taken up by achieving the right position. Once the injection is finished you will be monitored for any side effects before you can go home.
Post Procedure
Some patients experience a feeling of pressure during the injection, a tingling feeling or a burning sensation this is normal and should subside. On completion of the procedure, patients can complain of “pins and needles” in their extremities and this is why you cannot drive for 24 hours and require someone to assist you home. If the sensation is sharp alert your doctor or the Radiologist.
Improvements in pain from an epidural injection usually occur progressively overtime.