a.k.a. Caudal Block, Transforaminal
Exam time: 30 minutes
Most exams require patient to remain at CAI 30 minutes post-procedure.
Epidural steroid injections provide diagnostic data and pain relief
by delivering local anesthetic and anti-inflammatory steroid medications
onto the surface of the spinal column. This procedure addresses inflammation--which
may result in short term or long-term pain relief--while it provides
valuable information on the source of the patient's pain.
Patients will be awake throughout the test. A radiologist will position
a thin needle in epidural space. The contrast material will then
be injected using fluoroscopic guidance. The medications will be
injected next, which may create a pressure sensation in the lower
back and/or lower extremities.
Preparation/Restrictions:
- Stop blood thinners 4 days in advance; stop pain medication
eight hours in advance
- Patient should bring previous films
- Patient will need a driver.
Side Effects:
Side effects of the steroid medications--which affect only 5% of patients
and disappear within 1-3 days--include facial flushing, insomnia,
and occasional low grade fever, and increase in blood sugar. Patients
may also experience numbness in the lower extremities after the procedure.
Due to the effects of certain medications, the patient's driving
reflexes may be impaired. He/she should arrange in advance for a
driver or request assistance from CAI.
| Frequently
Asked Questions: |
Q: How will the patient
feel after the procedure?
A: Patients may experience numbness and/or relief from symptoms
for up to six hours after the injection. The usual symptoms may
then return and may possibly be worse than usual for a day or two.
Q: When will the pain relief medication take effect?
A: The beneficial effects of the steroids usually require 2-3.
If there is no change in the patient's symptoms after a week,
investigation into other potential sources of pain may be warranted.
Q: Would additional injections increase the patient's
pain relief?
A: If an initial injection provided a certain amount of relief,
a second injection might strengthen the pain relief effect. Also,
if the patient's pain subsides, but begins to return weeks or months
later, additional injections--up to six a year--are possible. They
must be ordered by your referring physician. |
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