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Epidural Steroid Injections

Epidural Steroid Injections

The spinal cord is sheathed in several protective layers, the outermost of which is a tough fibrous substance known as the dura. Surrounding this protective sheath is another protective layer of mostly fat in a region referred to as the epidural space. This space is the target of epidural injections, in which potent anti-inflammatory steroids are injected into this fatty layer to reduce compression on the spinal cord and nerves, reducing pain and permitting the body time to compensate for damaged structures. In this way these injections can provide long term relief for patients in a minimally invasive manner, and allow for the potential of improvement even after the effects of the steroids have worn off. These injections are guided by fluoroscopy or x-ray with contrast to ensure they are made to the target area, and typically include a local anesthetic to reduce pain experienced during the procedure itself.

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Three types of epidural injections

Three types of epidural injections exist, including the interlaminal, transforaminal, and caudal approach. All are guided by a fluoroscopic x-ray. In the interlaminar approach, the needle is placed at the back of the epidural space, and the steroid is applied broadly. For the transforaminal approach, the needle is applied to the nerve sheath of a nerve exiting the spinal column, which then travels back up towards the spinal cord for a more targeted effect. Finally, the caudal approach is applied directly above the sacrum or tailbone to reach the very base of the epidural space, and may affect several levels of the spinal cord at once. 

The results of epidural injections may typically be felt in the first three days following the procedure, but may take up to a week to be noticeable. Some patients will also experience a slight increase in pain in the first few days. Rarely, patients may not tolerate the steroids well, and can experience symptoms such as flushing of the face and chest, an increase in temperature, anxiety, difficulty sleeping, changes in menstrual cycle, and temporary water retention. Steroid injections have been performed for many decades, though, and have an excellent safety profile.

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The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this web site is for general information purposes only. Dr. Paul makes no representation and assumes no responsibility for the accuracy of information contained on or available through this web site, and such information is subject to change without notice. You are encouraged to confirm any information obtained from or through this website with other sources, and review all information regarding any medical condition or treatment with your physician. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY SEEKING MEDICAL TREATMENT BECAUSE OF SOMETHING YOU HAVE READ ON OR ACCESSED THROUGH THIS WEB SITE.

Dr. Paul does not recommend, endorse or make any representation about the efficacy, appropriateness or suitability of any specific tests, products, procedures, treatments, services, opinions, health care providers or other information that may be contained on or available through this web site. DR. PAUL IS NOT RESPONSIBLE NOR LIABLE FOR ANY ADVICE, COURSE OF TREATMENT, DIAGNOSIS OR ANY OTHER INFORMATION, SERVICES OR PRODUCTS THAT YOU OBTAIN THROUGH THIS WEB SITE. www.paulspine.com/legal/disclaimer.

Individuals’ outcomes may depend on a number of factors, including but not limited to patient characteristics, disease characteristics and/or surgeon experience.

All logos and names are trademarks or registered trademarks of their respective owners.

©2021 Ronjon Paul MD. All rights reserved.

Privacy Policy   |  Terms of Use   |   Disclaimer   |   Sitemap

Disclosures & Important Information

The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this web site is for general information purposes only. Dr. Paul makes no representation and assumes no responsibility for the accuracy of information contained on or available through this web site, and such information is subject to change without notice. You are encouraged to confirm any information obtained from or through this website with other sources, and review all information regarding any medical condition or treatment with your physician. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY SEEKING MEDICAL TREATMENT BECAUSE OF SOMETHING YOU HAVE READ ON OR ACCESSED THROUGH THIS WEB SITE.

Dr. Paul does not recommend, endorse or make any representation about the efficacy, appropriateness or suitability of any specific tests, products, procedures, treatments, services, opinions, health care providers or other information that may be contained on or available through this web site. DR. PAUL IS NOT RESPONSIBLE NOR LIABLE FOR ANY ADVICE, COURSE OF TREATMENT, DIAGNOSIS OR ANY OTHER INFORMATION, SERVICES OR PRODUCTS THAT YOU OBTAIN THROUGH THIS WEB SITE. www.paulspine.com/legal/disclaimer.

Individuals’ outcomes may depend on a number of factors, including but not limited to patient characteristics, disease characteristics and/or surgeon experience.

All logos and names are trademarks or registered trademarks of their respective owners.

Privacy Policy   |  Terms of Use   |   Disclaimer   |   Sitemap

©2021 Ronjon Paul MD. All rights reserved.

DAY OF SURGERY INFORMATION

Edwards Hospital

Arrival & Directions

Drive to the South parking garage. Free Valet parking is available during business hours. If you self-park, take the elevator from the garage to the first floor to enter the main hospital lobby. Wheelchairs are available if needed. Take the D elevator to the 2nd floor. Proceed to the Surgical and Endoscopy Check-In Desk. Here you and your family will be checked in and escorted to the Pre-op Area to be prepared for surgery. Up to two family members may wait with you until you are taken to surgery. Your family may then wait in the Surgical Waiting room until notified by the surgeon that the surgery has been completed. A receptionist will take down contact information so that your family may be easily reached to speak with Dr. Paul. Complimentary coffee is available for your family while in the Surgical Waiting room. The cafeteria and gift shop are on the ground floor in the North area of the hospital and the coffee shop is in the South area of the hospital for your family’s convenience.

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In the preoperative room you will be prepared for surgery. The team will be checking your vital signs, starting your IV, validating your medications, health history, lab results and any follow up for additional testing needed. At this time, they will obtain your consent for surgery and answer any questions you may still have. Your anesthesiologist will see you and your family prior to your surgery. Dr. Paul, Adam or Kevin  will mark your surgical site. You will be escorted to the operating room by cart. Your family can wait in the surgical waiting room. Dr. Paul will call them when surgery is completed.  If he can not reach them, he will leave a message with the Patient Liaison. Following surgery you will be taken to the Post Anesthesia Care Unit (PACU) where you will recover for an hour or more. During this time, pain and nausea control will be established and your vital signs will be monitored frequently.