LUMBAR and CERVICAL EPIDURAL SPINAL INJECTIONS (ESI’s)

LUMBAR and CERVICAL EPIDURAL SPINAL INJECTIONS (ESI’s)

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One treatment that is frequently recommended for patients with spine problems are epidural steroid injections (ESI’s). They are particularly effective for patients who have radiculopathy (nerve pain) and are thought of as ‘conservative care” though they are often done in surgery centers or small OR’s.

Properly administered using fluoroscopy (live x-ray), a corticosteroid (Dexamethasone) is injected around the affected nerve into your neck or low back at a particular level (location as determined by your symptoms and imaging). This medication is used to reduce the inflammation around the nerves thereby reducing your pain. If a short acting anesthetic agent is used (lidocaine) in the lumbar area, this is also diagnostic as the pain should be immediately diminished for an hour or so after injection. This will tell the physician 1) they have a well positioned injection and 2) the pain is being generated at this level.

As with any surgical procedure or injection, certain risks must be considered. Injury to nerve root(s) resulting in paralysis, excessive bleeding, weakness or infection are possible risks of this procedure. Although such complications are rare, you should feel free to discuss the question of risk with your doctor. There is also documentation that the administration of steroids can increase osteopenia and osteoporosis.

  • It may take a few days before you begin to feel better after your spinal injections.
  • There is the chance that you may experience some flushing or palpitations following the spinal injections. Diabetics may notice an elevation of blood sugar (glucose) levels. This tends to be a transient effect. These are not side effects or allergic reactions, but rather a normal action of the medication.
  • While everyone’s pain levels and tolerances differ, the amount of relief you get from the spinal injections depends on your particular symptoms and condition. In some cases, multiple spinal injections may be required. You will get the maximal benefit of the spinal injection within the first 7 days. If the first two injections are ineffective, another treatment should be sought.
  • You should be able to return to your usual activities 24 hours post injection.

Citations

  • Sencan S, Ozcan-Eksi EE, Cil H, Tay B, Berven S, Burch S, Deviren V, Demir-Deviren S. The effect of transforaminal epidural steroid injections in patients with spondylolisthesis. J Back Musculoskelet Rehabil. 2016 Mar 27; PubMed PMID: 28372316
  • Sharma AK, Vorobeychik Y, Wasserman R, Jameson J, Moradian M, Duszynski B, Kennedy DJ, Standards Division of the Spine Intervention Society.. The Effectiveness and Risks of Fluoroscopically Guided Lumbar Interlaminar Epidural Steroid Injections: A Systematic Review with Comprehensive Analysis of the Published Data. Pain Med. 2017 Feb 1;18(2):239-251. PubMed PMID: 28204730

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Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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