Cervical Transforaminal Epidural Steroid Injection

Different types of spinal injections carry different risks. Your doctor will explain the specific risks of your procedure. These potential risks are common to many spinal injections:

• Nerve problems that cause arm or leg weakness
• Increasing feelings of numbness
• Briefly increased pain or severe increased pain
• Incontinence
• A type of post-injection headache (“spinal headache”)
• Bleeding, infection (rare)
• Stroke
• Spinal cord injury

A cervical transforaminal epidural steroid injection can provide many benefits:

• May relieve or diagnose pain
• Is less invasive than surgery, fewer risks
• Allows fast recovery
• Does not require a hospital stay

The actual injection takes only a few minutes, but plan on 30 to 60 minutes for the whole procedure. You will remain awake and able to communicate the entire time. Your procedure will include:

• Monitoring. You may have devices attached to you to check your heart rate and breathing.
• Sedative. You may be given a sedative to help you relax.
• Position. You may lie face down, face up, or on your side.
• Local anesthetic. You’ll be given a local anesthetic near the injection site to numb the skin. This usually feels like a pinprick with some burning and only lasts a second.
• Fluoroscopic x-ray guidance. The doctor may inject a contrast dye that helps identify specific parts of your spine and confirm correct needle placement.
• Injection. Numbing medicines or anti-inflammatory medicines (steroids) will be injected into your spine.

After the procedure, you may stay in a recovery area and have your vital signs (heart rate, blood pressure, breathing rate) monitored. You should be able to walk immediately after the procedure, although some patients experience leg weakness, numbness, or tingling for a few hours. You may be asked to fill out some paperwork before leaving.

These are things to be aware of as you’re recovering at home:

• Driving. Someone may need to drive you home after the procedure. Your doctor will likely allow you to resume driving the next day.
• Possible side effects. You may experience briefly increased pain, headaches, or trouble sleeping. These should go away in the first few days.
• Food and drink. You may be asked not to eat or drink for a few hours.
• Activity. You may be asked to take it easy on the day of the injection. But it may help to get up and move around every hour or so. You should be able to resume normal activity the next day. Walk around if you feel up to it, but avoid activities that may strain your back.
• Showering and bathing. You can take a shower, but avoid baths or pools for 48 hours.
• Returning to work. Ask your doctor when you can return to work.
• Follow up. Be SURE to follow up with your doctor in 2 weeks or as otherwise instructed.

Epidural steroid injections can treat pain in a large region of the body. Steroid medicine is injected into the epidural space between two vertebrae or near a nerve. Specifically, a cervical transforaminal steroid injection is given in the neck or upper back area, also called the cervical area. The medicine moves up and down the spinal canal to coat the nerve roots near the injection area.

You might need a spinal injection if you have back pain that has not responded to physical therapy or other treatments. An alternative to back surgery, spinal injections can be used to:

• Diagnose your pain. Your doctor will inject numbing medicine (anesthetic) into the cervical area of your spine, blocking all feeling. If the pain is relieved, the doctor will better understand the source and how to treat it. If not relieved, then there may be a different source that may require more or different types of injections for a sound diagnosis.
• Relieve your pain. Your doctor can use spinal injections to relieve your pain, reduce swelling, or improve mobility. An anti-inflammatory medicine, such as cortisone, is injected directly into the place the pain comes from. Depending on the medicine injected, you may feel pain relief right away, or it may take a few days or more to take effect. Pain relief may be temporary (lasting several weeks or months) or long lasting.