Spinal Injections After evaluation of your symptoms, x-rays and scans, your surgeon may decide to offer you a course of spinal injections. The aim of the injections is to reduce the pain and inflammation, which in certain types of spinal problems, can be long lasting and may obviate the need for spinal surgery.
Your surgeon will decide which of the two types of spinal injections will benefit you:
- Facet Injection or Facet Block; or
- Transforaminal Epidural Steroid Injection or A Nerve Root Block.
Facet Injection :
The facet joints are paired joints in the back that have apposing surfaces of cartilage (cushioning tissue between the bones) and a surrounding capsule. Twisting injuries can cause damage to one or both facet joints, and cartilage degeneration associated with aging may also cause pain.
In cases where the facet joint itself is the pain generator, a facet block injection can be performed to alleviate the pain. Similar to Selective Nerve Root Blocks(SNRBs), facet block injections are a diagnostic tool used to isolate and confirm the specific source of back pain for the patient. Additionally, facet blocks have a therapeutic effect as they numb the source of pain and soothe the inflammation for the patient.
Epidural Injections :
The Epidural means "around the spinal cord." Typically, epidural injections are performed in a doctor's office or the hospital. They're usually given by anesthesiologists, physiatrists, or interventional radiologists with special training.
Before receiving an epidural injection, you will probably undergo an imaging test. This may involve a CT scan or an MRI of the back. The test allows the doctor to identify possible causes of back pain.
The epidural injection takes place in several steps :
- The skin will be cleaned and injected with an anesthetic to numb it.
- The doctor will insert a needle through the skin toward the spine.
- The doctor will use a machine that produces live X-ray video called fluoroscopy. With it, the doctor will maneuver the needle between the bones of the spine.
- Using a contrast dye, the doctor will confirm the needle is placed in the epidural space. That's the space between the spine and the spinal cord inside it.
- When the needle is in position, the doctor will inject a solution into the epidural space. The solution contains a steroid medicine, also called corticosteroid, and usually an anesthetic medicine, too.
The epidural injection is usually not painful because of the numbing medicine used at the start. Many people do have mild tenderness for up to a few days after the injection.
