Spinal epidural injection
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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)
- interlaminar epidural injection
- transforaminal 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 dissect adhesions and change the focal PH in favor of 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. In multi-level nerve compression, a single interlaminar epidural injection will mean only a single injection is required.
For equipment, indications and contraindications see spinal interventional procedures.
The success rate reported in the literature is variable: 23-84%