Lumbar Epidural Steroid Injection

A lumbar epidural steroid injection procedure is performed to relieve low back and radiating leg pain.  Steroid medication can reduce the swelling and inflammation caused by spinal conditions.  In some cases it may be necessary to repeat the procedure as many as three times to get the full benefit of the medication.  Many patients get significant relief from only one or two injections

Procedure

The patient lays face down.  A cushion under the stomach area provides comfort and flexes the back.  In this position, the spine opens and allows for easier access to the epidural space.  A fluoroscope assists the physician in locating the appropriate lumbar vertebra and nerve root.  A local anesthetic is used to numb the skin

All the tissue down to the surface of the lamina portion of the lumbar vertebra bone is anesthetized.  The physician slides a thicker needle through the anesthetized track.  Using the fluoroscope for guidance, the physician slides the needle toward the epidural space between the L-4 and L-5 vertebra.  A contrast solution is injected.

The physician uses the fluoroscope to see the painful area and to confirm the correct location of the needle tip.  A steroid-anesthetics mix is injected into the forminal epidural space, bathing the painful nerve root with medication.