Epidural Steroid Injections/Interlaminar Technique
Epidural injections are typically done for people with radicular pain (i.e., neck/arm pain, or low back/leg pain). The epidural space is within the spinal canal and extends from the base of the skull to the sacrum. All the nerve roots course through the epidural space. Irritation of the nerve roots can be caused by degenerative disc disease, herniated or bulging disc, spinal stenosis, bone spurs, arthritis, or scar tissue from prior surgeries. After appropriate anesthetic (usually only subcutaneous local anesthetic), a needle is placed into the epidural space at the level of the problem between two vertebrae (interlaminar). Injection of 4-10 cc of a mixture of local anesthetic/steroid is then placed in the epidural space to bathe the nerve roots at not just one level but several levels. The local anesthetic quiets the nerves down while the steroid is to decrease the inflammation of the nerve roots. If an initial injection is helpful, typically a series of two to three injections is done.