Epidural spinal injections are one of the more frequently performed spinal interventional procedures. Three approaches to the epidural space exist:
caudal epidural injection (via the sacral hiatus)
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interlaminar epidural injection
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 can also dissect adhesions and alter the focal pH in favour of improved nerve function.
The transforaminal approach allows a more targeted delivery to a more specific region. These injections can be more useful clinically and can help guide further injections and surgical management. Moreover, in cases of multi-level nerve compression, a single interlaminar epidural injection can effectively address multiple affected levels, reducing the need for multiple separate injections.
Procedure
For equipment, indications and contraindications see spinal interventional procedures.
Outcomes
The success rate reported in the literature is variable: 23-84%
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