About Lumbar Epidural Steroid Injection

Overview
The surgeon performs this injection procedure 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.  In some cases it may be necessary for the surgeon to repeat the procedure as many as three times to get the full benefit of the medication.  However, many patients receive significant relief from only one or two injections.

Step 1
The patient lays face down during this procedure with a cushion placed under the stomach area to provide comfort and flex the back.  In this position the spine will open allowing easier access to the epidural space.  The physician will use a fluoroscope to assist in locating the appropriate lumbar vertebra and nerve root, and uses a local anesthetic to numb the skin.

Step 2
The surgeon then anesthetizes all the tissue, down to the surface of the lamina portion of the lumbar vertebra bone.

Step 3
Then the physician slides a thicker needle through the anesthetized track.

Step 4
Using the fluoroscope to see, the surgeon guides the needle toward the epidural space between the L-4 and L-5 vertebral space.

Step 5
A contrast solution is injected so the physician can use the fluoroscope to see the painful areas and to confirm the correct location of the needle tip.

Step 6
The physician injects a steroid-anesthetics mix into the foraminal epidural space, bathing the painful nerve root with soothing medication..

End of Procedure
The physician removes the needle and applies a small band-aid to cover the tiny needle surgace wound.