Epidural Steroid Injections

The epidural space surrounds the spinal canal and is in close proximity to several pain generating structures including the intervertebral disc and spinal nerve roots.  An ESI involves placing a needle into the epidural space to inject medications such as anesthetics and corticosteroids to decrease inflammation and pain.  An epidural steroid injection can be done at virtually any level of the spine, including cervical, thoracic, lumbar or caudal.  This procedure is performed under fluoroscopic guidance to confirm accuracy of location and safety to the patient.  For patient comfort a mild sedation is administered before the procedure begins.  All of are procedures are done at the Maplewood Ambulatory Surgery Center. 

After sedation is administered, a local anesthetic is administered at the procedure site.  Using fluoroscopic guidance and anatomic landmarks, a specialized needle is placed through the skin and into the epidural space.  A small amount of contrast dye is injected into the epidural space to verify accurate needle position.  The dye injection can often provide diagnostic information: this is called an epidurogram.  Finally, the steroid and anesthetic mixture injected into the epidural space.  

Reduced inflammation in target sites, i.e. surrounding area of injured disc and/or affected spinal nerve roots.  This usually results in a notable decrease of back and/or extremity pain.

The procedure takes ten to fifteen minutes plus recovery time which is approximately thirty minutes. 

Patients must not eat or drink six hours prior to their procedure.  Blood thinning agents (i.e. Coumadin, Aspirin, Plavix etc.) must be stopped seven days prior to procedure.  Patients who received sedation are not permitted to drive themselves home, therefore they must have a responsible adult accompany them to their procedure.