Cervical Interlaminar Epidural Steroid Injections

Cervical Interlaminar Epidural Steroid Injections - for neck and arm pain

A cervical interlaminar epidural steroid injection is an outpatient procedure for treating neck, upper back, shoulder, and arm pain.

This information will explain what it is, Dr. Singer can determine if it is for you.

What is the epidural space? The dura is a proactive covering of the spinal cord and its nerves. The space surrounding the dura is called the epidural space. In the neck it is called the cervical epidural space.

What causes pain in the epidural space? The cervical area of the spine has seven bones, called vertebrae. Soft discs found between these vertebrae cushion them, hold them together, and control motion. If a disc tears, chemicals may leak out. This can inflame the dura or nerve roots and cause pain. A large disc tear may cause a disc to bulge, inflaming the dura and nerve roots, and cause pain. Bone spurs, called osteophytes, can also press against the nerve roots and cause pain.

How do I know if I have disc and nerve root pain? If you have pain in your neck or upper back when you move your head or neck, you may have cervical disc or dural inflammation. If pain travels to your arms when you move your head or neck, you may have nerve root inflammation. Common tests such as MRIs can show disc bulges and nerve root compression, but may not show a torn and leaking disc. A cervical epidural injection may provide relief if disc, dural, or nerve root inflammation is causing your pain.

What is an interlaminar cervical epidural steroid injection? In a cervical epidural injection, a corticosteroid (anti-inflammatory medication) is injected into the epidural space to reduce inflammation. A local anesthetic (numbing medicine) may also be injected. The simplest way from the back of the spine. This is called an interlaminar injection. Medications to stop before the procedure. Stop Plavix 7 days before the procedure. Stop coumadin, warfarin, and aspirin 5 days before the procedure. Check with Dr. Singer about any other medications you take. Risks. Bleeding, infection, nerve injury, spinal cord injury, abscess or blood clots, paralysis, spinal fluid leak with headache, and failure to relieve pain are all risks. Discuss specific risks with Dr. Singer prior to the procedure during consultation.

What happens during an injection? A local anesthetic will be used to numb your skin. The doctor will then insert a thin needle directly into the epidural space. Fluoroscopy, a type of x-ray, must be used to ensure the safe and proper position of the needle. A dye may be used to make sure the needle is at the correct spot. Once Dr. Singer is sure the needle is correctly placed, the medicine will be injected. Sedation. Rarely, when sedation is required, you should eat or drink nothing for six hours before your procedure, continue your normal medications (except blood thinners) with a sip of water, and you should have a driver transport you home.

What happens after an injection? You will be free to get re-dressed and check out at the front desk. It may help to move neck in ways that hurt before the injection, to see if the pain is still there, but do not overdo it. Take it easy for the rest of the day. You may feel immediate pain relief and some numbness in your neck and arm for a limited time after the injection. This may indicate the medication has reached the right spot. You can usually return to work the day after the injection. Your pain may return after this short pain-free period or may even be a little worse for a day or two. It may be caused by needle irritation or by the steroid itself. Steroids usually take two or three days to start working, but can take as long as a week.

How long can I expect pain relief? The extent and duration of pain relief may depend on the amount of disc, dural or nerve root inflammation. Other coexisting factors may be responsible for your pain. Sometimes an injection brings several weeks to months of pain relief and then further treatment is needed. Other times, a single injection brings long-term pain relief. If your pain is caused by injury to more than one area, only some of your symptoms may be helped by a single injection.

This information is for general education only. Specific questions or concerns should always be directed to your doctor. Your doctor can explain possible risks or side effects.