Transforaminal epidural steroid injections lumbosacral radiculopathy

Kenalog in blood - Derby et al. "Size and aggregation of corticosteroids used for epidural injections"

  • Depo-Medrol also formed large aggregations in the study by Tiso et al [6]
  • Celestone Soluspan formed large aggregations only in the Derby et al study  [7 ]
  • It is speculated that these large aggregates occlude smaller vessels, and thus lead to infarction .
  • Injection of methylprednisolone vs dexamethasone vs prednisolone into the vertebral artery of pigs – see summary of study here

    NOTICE OF FINANCIAL INTEREST: This is to serve as legal notice that the physicians at this location providing my care have a financial interest in The Pain Relief SurgiCenter, Ambulatory Surgery Center of Killeen, Pain Specialists of Austin Pharmacy and Hunter’s Creek Pharmacy. All patients are free to choose any facility for obtaining services or prescriptions that are ordered for them during the course of their care. Physicians include the following: Hans Bengtson, Scott Campbell, Teddrick Dunson, Daniel Frederick, Douglas Freiberger, Genero Gutierrez, Gary Heath, Matthew Hellman, Vivek Mahendru, Pankaj Mehta, Eric Miller, Rahul Sarna, Samuel Stevens, Derrick Wansom, Stuart Zweikoft.

    As mentioned above, there may be more than one spinal structure causing your spine pain.  Sometimes, there are multiple causes for your spine pain or radiculopathy.  In this case, Dr. Lee may recommend alternative treatment options or steriod injections.  For example, if your sciatica/leg pain or hand pain improves with epidural steroid injection but you still have low back pain or neck pain, you may benefit from facet joint injections.  But, whatever the case, you will need further evaluation by Dr. Lee to decide on further treatment.  Remember that there are multiple treatments available now for pain and just because one method yielded partial or no response DOES NOT necessarily mean you will “just have to live with the pain”!

    In an SNRB, the nerve is approached at the level where it exits the foramen (the hole between the vertebral bodies). The injection is done both with a steroid (an anti-inflammatory medication) and lidocaine (a numbing agent). Fluoroscopy (live X-ray) is used to ensure the medication is delivered to the correct location. If the patient’s pain goes away after the injection, it can be inferred that the back pain generator is the specific nerve root that has just been injected. Following the injection, the steroid also helps reduce inflammation around the nerve root.

    Transforaminal epidural steroid injections lumbosacral radiculopathy

    transforaminal epidural steroid injections lumbosacral radiculopathy

    In an SNRB, the nerve is approached at the level where it exits the foramen (the hole between the vertebral bodies). The injection is done both with a steroid (an anti-inflammatory medication) and lidocaine (a numbing agent). Fluoroscopy (live X-ray) is used to ensure the medication is delivered to the correct location. If the patient’s pain goes away after the injection, it can be inferred that the back pain generator is the specific nerve root that has just been injected. Following the injection, the steroid also helps reduce inflammation around the nerve root.

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