Lumbar Spinal Injections

July 14, 2010  |   Posted by :   |   Services   |   0 Comment»

Low back pain can be a debilitating problem for many people.  Conservative treatment with oral medications and exercises can be successful in curing the majority of people with low back pain.  For those individuals whose pain is not resolved may need to have a lumbar spinal injection.  There are different types of lumbar injections, and the majority of spinal injections in the lumbar spine are done with fluoroscopy or X-RAY guidance. The three types of lumbar injections that I do are the following:

Lumbar Epidural Steroid Injections

 Patients with pain in their back that radiates down their legs are excellent candidates for lumbar epidural steroid injections.  A MRI is helpful prior to the injection to help correlate the cause of the patient’s symptoms.  The steroid that is injected into the epidural space will decrease the inflammation around the nerve that is irritated.  The two approaches that I use are interlaminar and transforaminal which depends on where the compression of the nerve is coming from.  Lumbar epidural steroid injections can be given two weeks apart for a total of 3-4 in 1 year period.  Please see the diagram for the visual on epidural injections

Lumbar Facet Injections

Facet joints of the lumbar spine prevent the vertebral bodies from moving forward on one another.  Over time degenerative changes can occur in the fact joints leading to bone spurs and breakdown of the joints which can cause low back pain.  Pain from facet joints usually stays in the low back and may worsen with back extension.  X-Rays and a MRI are very helpful for planning an injection.  The steroid is injected directly in the facet joint and decreases the inflammation which eliminates the pain.  Facet joint injections can be done 3-4 times a year only.

Nerve Root Blocks

Patients that have pain from a specific nerve root or need help diagnosing the origin of the pain are candidates for a nerve root block.  X-RAY’s and a MRI are usually done prior. The nerve root block is an injection consisting of a local anesthetic and a steroid medication that is guided and injected in the nerve sheath with the help of X-Ray guidance and contrast dye.  The steroid medication decreases inflammation around the nerve to help eliminate the pain.

Check out the following animated video from spine-health.com

L4-5 Interlaminar Epidural Steroid Injection

Other good resources are:

 www.knowyourback.org

www.spine-health.com

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