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Medical Conditions: Lumbar Transforminal Epidural Steroid Injection

Overview
This injection procedure is preformed to relieve low back and radiating leg pain. The steroid medication can reduce the swelling and inflammation caused by spinal conditions such as spinal stenosis, radiculopathy, sciatica and herniated discs.

Fluoroscope Inserted
The patient lies face down. A cushion is placed under the stomach area to provide comfort and flex the back. The position causes the spine to open, allowing for easier access to the epidural space. The physician uses a fluoroscope to locate the appropriate lumbar vertebra and nerve root, and a local anesthetic numbs the skin.

  1. Tissue Anesthetized
    All the tissue down to the surface of the vertebral transverse process is anesthetized.
  2. Needle Inserted
    The physician slides a thin bent needle with a slightly curved point through the anesthetized track.

    Foraminal Space Accessed
    With the aid of the fluoroscope, the physician carefully guides the needle into the foraminal space near the nerve root.

  3. Contrast Dye Inserted
    The physician injects a contrast solution and uses the fluoroscope to see the painful areas and confirm the correct location of the needle tip.
  4. Steroids Injected
    A steroid-anesthetics mix is injected into the foraminal epidural space, bathing the painful nerve root with soothing medication.

End of Procedure
The needle is removed, and a small band-aid is used to cover the tiny needle surface wound. In some cases it may be necessary to repeat the procedure as many as three times to provide the full benefit of the medication. However many patients feel significant relief from only one or two injections.

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