Spinal epidural injection

Last revised by Dr Dai Roberts on 15 May 2021

Epidural spinal injections are one of the more frequently performed spinal interventional procedures. Three approaches to the epidural space exist:​

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.  

Procedure

For equipment, indications and contraindications see spinal interventional procedures.

Outcomes

The success rate reported in the literature is variable: 23-84% 

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Cases and figures

  • Case 1: interlaminar needle
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