Lumbar Transforaminal Steroid Injection
Lumbar transforaminal epidural steroid injections provide significant relief from pain in the lower back and leg, commonly known as sciatica. Duration of relief may last up to a year or longer, and represents an important non-surgical approach to patient pain management. Blocking pain directly at the origin increases mobility, allowing for an easier transition into physical therapy and an active lifestyle. Lumbar transforaminal epidural steroid injections are a minimally invasive outpatient procedure, that allow for normal activities to be resumed the following day. All injections are performed in DISC’s ultra clean surgery center, which far exceed hospital-based standards for cleanliness and safety. Surgical centers are 100% HEPA and UVC (ultraviolet) filtered, and maintains a record of zero MRSA infections while hospital range from 5-10% nationally. Within DISC’s fully integrated care model, this procedure paired with appropriate physical and soft tissue therapy, provide true and lasting relief, and for many patient avoids the need for surgery altogether.
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Symptoms and Anatomy
Lumbar transforaminal epidural steroid injection sounds intimidating. It is more easily understood if broken down into individual terms. Lumbar refers to the lower section of the back, an area of five vertebrae with nerve extensions down the lower back and thigh. Vertebral problems in this area, such as a bulging or degenerative disc, often result in compression or distortion of these nerves. This can manifest as back and leg pain (radicular pain). Transforaminal literally means to go through an opening, describing the path the nerve root leaves the spinal canal and the area most commonly being compressed, causing pain. The epidural space is the outermost section of the spinal canal and is the location where the steroid injection will be focused. To summarize, a steroid injection is made into the symptomatic epidural space of the lumbar section of the spine, targeting nerve roots leaving the spinal canal. Focusing the steroid injection on this section maximizes relief against symptoms of pain and numbness. Once the initial pain is blocked by the injection allowing greater motion and flexibility, strength conditioning and mobilization help build and maintain the muscular support system of the back helping to provide relief and prevent recurrence These services are available in house at the DISC Soft Tissue Center.
Lumbar Injection Procedure
A lumbar transforaminal epidural steroid injection is an outpatient procedure that occurs under no anesthesia or light sedation. Using real time x-ray (fluoroscopy) a needle is placed to the affected nerve area. The needle used is smaller than traditional epidurals. A radiopaque dye is injected to ensure the needle is oriented precisely on the problematic nerve root. The steroid injection is comprised of two key components: a steroid and local anesthetic. This combination of anti-inflammatory and pain suppression decreases swelling and discomfort of the nerve root.
The procedure generally takes 15-20 minutes, after which the patient is observed for 45 minutes. After the procedure, patients return home and typically rest for the rest of the afternoon. Benefits from the procedure are usually detectable within the first few hours after the procedure, although maximal improvements are noted to take up to 6 weeks. A series of up to three injections may be recommended for some patients. While many physicians performs this procedure in a office setting, all injections at DISC are performed in an ultra-clean surgery center setting. Patients enjoy a safe, attentive, private experience, in an elegant and comfortable setting.
Relief and Concerns
Lumbar transforaminal epidural steroid injections treat the origin of spine related pain. The minimally invasive, non-surgical approach offers significant relief and when combined with physical therapy and can be a long term solution for spine related pain. Lumbar transforaminal epidural steroid injections expedite the healing process by allowing the patient to resume an active lifestyle the very next day.
Lumbar transforaminal epidural steroid injections are exceptionally safe, but there is a small risk of infection or lingering pain at the site of injection. In very select cases the onset of headaches and blood pressure changes may occur, in which case a medical professional should be contacted.
If pain does not subside after a lumbar transforaminal epidural steroid injection, there is a good possibility that discomfort does not stem from the nerve root, thus serving as a highly reliable procedure for diagnosing the source of the symptoms or that surgery may be required.
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