Spinal Injection

Spine Injection Treatment

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Spinal Injections


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Kyphoplasty/ Vertebroplasty

Spinal injections are pain relieving procedures. A small mixture of steroid and local anesthetic is injected near painful pathology. Spinal injections immediately reduce pain by local anesthetic effect. Long term pain relief is provided by reduced inflammation caused by steroids.

Types of injections for back pain:

• Epidural Steroid Injection (ESI):

   A needle is inserted in the epidural space (area between dura and inner surface of vertebral arch) from a posterior approach. A mixture of varying doses of local anesthetic and steroid is injected in this space. This procedure is suited for patients with spinal canal stenosis and multilevel lumbar pathologies. Lumbar ESI is a very familiar approach as it is the approach commonly used to anesthetize lower limbs for various surgeries. Local anesthetic is avoided for Cervical ESI to reduce any chance of temporary numbness in cervical spinal cord.

• Trans-Foraminal Epidural Steroid Injection (TFESI):

   A lateral approach is used to inject medicines in vertebral foramen. This procedure is done under fluoroscopy guidance to direct needle to correct level and site. TFESI is also called Root Block as it target a single root in the foramen. Multiple TFESI can be given for multilevel root compression. Primarily used for lumbar nerve roots, TFESI can also be given for cervical and thoracic nerves.

• Caudal Epidural Injection:

   This procedure is similar to epidural injection; however, site of entry for medicines is from sacral bone. This procedure is best suited for lower lumbar spine pathologies (L4-5, L5-S1).

• Facet Block:

   Mixture of local anesthetic and steroid is injected inside the arthritic facet joint or the nerve supplying the facet joint is anesthetized. This procedure is done under fluoroscopy guidance. Facet block is done for both lumbar and cervical spine.

• Intra-Discal Injection:

   Medicine mixture is injected inside the disc material under fluoroscopy guidance. This lead to reduction in pain of disc origin (disc degeneration, annular tear etc.). This procedure is primarily used in lumbar disc degeneration.

Advantages of Spinal Injections:

• Spinal injections give immediate relief to patient’s symptoms.
• Spinal injections give long term relief due to anti-inflammatory effects of steroids.
• Spinal injections provide stepwise approach to patients suffering from spinal pathologies before deciding about the surgery.
• They help in confirming the diagnosis by assessing pain relief received after injection at the site of suspected pathology.
• Spinal injections help in postponing the surgery by providing required pain relief.
• They are helpful in providing symptomatic relief to patients where spinal pathology is either not obvious or not severe enough to require surgery.

Spinal Injections side effects:

• They do not cure primary pathology. Pain might return after the effect of medicines is over.
• Steroids are contraindicated in patients with uncontrolled diabetes as they can cause infection at the site of injection and can increase blood sugar.
• Spinal Injections a (especially ESI) are contraindicated in patients on blood thinners. Injection needle can puncture small veins around the spinal cord and cause bleeding in the spinal canal. This can compress spinal cord and cause symptoms of spinal stenosis, which might require surgery.

In essence, spinal injections provide good symptomatic relief to the patient. They are a good diagnostic tool and are commonly used as a stepwise treatment for spine pathologies.s 

Frequently asked questions:

Do spine injections work?

1. Spine injections can be effective in reducing pain and inflammation in many cases. However, the degree of effectiveness varies from person to person. They are often used as part of a comprehensive treatment plan that may include physical therapy, medications, and lifestyle changes.

Are spinal injections worth it?

The effectiveness of spinal injections depends on the individual’s condition and the underlying cause of their pain. Some people find significant relief from spinal injections, while others may not experience as much benefit. It’s important to discuss the potential benefits and risks with your healthcare provider to determine if they are worth it in your particular case.

What is the success rate of spinal injections?

The success rate of spinal injections depends on the underlying condition being treated and individual factors. Some people experience significant relief, while others may not respond as well. Your healthcare provider can give you a better idea of the expected outcomes based on your specific case.

How painful is a lumbar epidural steroid injection?

The pain experienced during a lumbar epidural steroid injection can vary from person to person. While the procedure can cause discomfort, it is typically well-tolerated. Local anesthesia is often used to numb the area before the injection, which can help minimize pain during the procedure.

How long do spinal injections last for?

The duration of pain relief from spinal injections can vary from person to person. Some individuals experience relief for a few weeks, while others may have more prolonged relief lasting several months. In some cases, multiple injections may be needed for sustained relief.

Are spinal injections dangerous?

Spinal injections are generally considered safe when performed by qualified healthcare providers. However, they do carry some risks, including infection, bleeding, nerve damage, or allergic reactions. The specific risks can vary depending on the type of injection and individual patient factors.

Is it safe to have an injection in the spine?

When performed by trained professionals in a sterile environment, spinal injections are generally safe. Your healthcare provider will assess your specific case and discuss the risks and benefits with you.

Is there any dark side of epidural steroid injection?

While epidural steroid injections can provide pain relief, there are potential risks and side effects, including infection, nerve damage, and transient increases in pain. In rare cases, repeated or improper use of steroids in epidural injections can lead to complications like osteoporosis or adrenal gland suppression. These risks should be discussed with your healthcare provider when considering this treatment option.

What is the epidural injection cost in rupees?

The cost of epidural injections can vary depending on the location, healthcare provider, and healthcare system. It is best to check with your local healthcare facility or provider for specific pricing information.

What is a spine injection for sciatica or herniated disc?

Spinal injections, including epidural steroid injections, are sometimes used to alleviate pain associated with sciatica or herniated discs by reducing inflammation and providing temporary pain relief. Majority of the times spine injections are done at L4-5 and L5-S1 levels.