Epidural spinal injections are one of the more frequently performed spinal interventional procedures.Three approaches to the epidural space exist:
- transforaminal epidural injection
- interlaminar epidural injection
- caudal epidural injection (via the sacral hiatus)
Corticosteroid injection acts with breaking down the inflammatory cycle and accumulated focal mediators such as prostaglandins; also direct injection into the epidural space results in dilution and dispersion of these inflammatory mediators and dissect adhesions and change focal PH in favor of nerve function .
The transforaminal approach allows small targeted delivery to a smaller region. The later two approaches require larger volumes, and higher doses of steroid, with a, therefore, greater likelihood of complication.
For equipment, indications and contraindications see spinal interventional procedures.
Success rate reported in the literature is variable: 23-84%
Spinal interventional procedures
spinal interventional procedures (general)
- epidural blood patch
- facet joint injection
- fluoroscopy-guided lumbar puncture
- sacroiliac joint injection
- spinal epidural injection
- transforaminal nerve root injection