Transforaminal Epidural Injection

Epidural glucocorticoid injections are commonly given to patients with leg and/or back pain to relieve such pain and improve mobility without surgery. These steroid injections buy time to allow healing to occur and/or as an attempt to avoid surgery after other conservatives (non-surgical) treatment approaches have failed. During a transforaminal injection, a small-gauge blunt needle inserted into the epidural space through the bony opening of the exiting nerve root.

The needle is smaller in size than that used during a conventional epidural approach. The procedure performed with the patient lying on their belly using fluoroscopic (real-time x-ray) guidance, which helps to prevent damage to the nerve root. A radiopaque dye injected to enhance the fluoroscopic images and to confirm that the needle is properly placed. This technique allows the glucocorticoid medicine to placed closer to the irritated nerve root than using conventional interlaminar epidural approach. The exposure to radiation is minimal.

Complications

Complications are rare but may include headaches, infections, blood pressure changes, bleeding, and discomfort at the needle insertion site. Use of steroids rarely causes an increase in blood sugar and blood pressure, as well as leg swelling. The major complication, that being damage to a nerve root is very rare. However, using a blunt needle may, even more, reduce the risk of this complication.