Background Information:

What are the other Names for the Procedure?

• Epidural Steroid Injections
• Injections to the Epidural Space

What is Epidural Injections radiology procedure? (General Explanation)

• Epidural Injections are given to provide relief from pain, swelling, and inflammation, around the spinal nerve roots and damaged nerves
• These are delivered into the epidural space of the spine, using fluoroscopy or CT scan
• Injections are filled with steroids, anti-inflammatory medicines, or anesthetics

What part of the Body does the Procedure involve?

These injections are delivered into the epidural space of the spine.

Why is the Epidural Injections radiology procedure Performed?

Epidural Injections are administered to:

• Relive pain caused by spinal stenosis, herniated disk, spinal nerve, or vertebrae damage
• Relieve pain back and leg pain, after a spinal surgery

What is the Equipment used? (Description of Equipment)

• A syringe is used to inject the medications into the spine
• Imaging techniques, such as fluoroscopy or CT scan, are used to place the needle at the exact spot
• CT scan equipment:
  • The CT scanner appears like a big box with a hole/opening
  • Examination table on which the patient is laying down slides into the hole
  • An x-ray tube and electronic x-ray detectors, rotate around the patient
  • Images are taken from a computer

What are the Recent Advances in the Procedure?

There have been no recent advances to replace or substitute Epidural Injections.

What is the Cost of performing the Epidural Injections radiology procedure?

The cost of Epidural Injections depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities. 

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding Epidural Injections and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.mayoclinic.org/diseases-conditions/back-pain/expert-answers/epidural-steroid-injections/FAQ-20058277

http://orthopedics.about.com/cs/backpain/a/epiduralsteroid.htm

Prior to Epidural Injections radiology procedure:

How does the Epidural Injections radiology procedure work?

• Epidural Injections are used to inject steroids, which reduce swelling and irritation around the nerves; this helps the nerves to heal
• Medications injected into the epidural space moves throughout the space and affects other nerves too

How is the Epidural Injections radiology procedure Performed?

• An intravenous (IV) line is placed in the patient’s arm, in order to deliver relaxation medications
• The patient is placed, either on their stomach or on their sides, depending upon where the medications are injected
• A local anesthetic is applied to the injection site, to numb the area
• CT scan or fluoroscopy is used to determine the exact location, where the injection must be administered
• After placing the needle, a contrast material is injected to check the distribution of the medication. The medications are injected slowly
• The IV line is removed after the procedure

Where is the Procedure Performed?

Epidural Injections are administered as an outpatient procedure in an out-patient surgery center facility or a hospital.

Who Performs the Procedure?

Epidural Injections may be administered by any of the following healthcare personnel:

• Radiologist
• Anesthesiologist
• Neurosurgeon
• Orthopedic surgeon
• Obstetrician/gynecologist

How long will the Procedure take?

The actual procedure may take about 5-10 minutes. However, there may be some waiting time involved, before and after the procedure.

Who interprets the Result?

The results of the procedure may be administered by any of the following healthcare personnel:

• Radiologist
• Anesthesiologist
• Neurosurgeon
• Orthopedic surgeon

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to administration of Epidural Injections:

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
• The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
• Specific instructions may be given to the patient, depending on the reason for administration of the injections
• Patient lies down on their stomach or side to give good access for the injection
• Patient needs someone to drive them home after the procedure

What is the Consent Process before the Procedure?

A physician will request your consent for administering Epidural Injections using an Informed Consent Form. 

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent. 

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of Epidural Injections:

• Pain relief
• Reduction in swelling or irritation

Following are the risks of Epidural Injections:

• Hot flashes may happen due to the medication reaction
• Injection may damage nerves
• Bleeding
• Headache
• Some patients may experience temporary worsening of pain right after the procedure, which eventually gets better
• Temporary bladder or bowel dysfunction may occur, due to nerve paralysis
• Infection at the injection site may occur
• Spinal cord injury, stroke, or possible death, if the needle is placed incorrectly

What are the Limitations of the Epidural Injections radiology procedure?

Limitations of Epidural Injections include:

• The effect is mostly temporary and does not provide long-term relief
• There may be a need for more injections in future, in order to get relief

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What are Epidural Injections?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place, during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required, after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• Is there any medication that needs to be taken for life, after the procedure?
• What are the costs involved?

During the Epidural Injections radiology procedure:

What is to be expected during the Epidural Injections radiology procedure?

During administration of Epidural Injections the following may occur:

• The patient may experience pressure, when the injection is given
• Burning sensation may be felt, when medications are injected in epidural space
• The patients should notify the physicians, if they experience any sharp pain, during the procedure

What kind of Anesthesia is given, during the Procedure?

Local anesthesia may be used to numb the area, where the injection is given, during the procedure.

How much Blood will you lose, during the Procedure?

Since the procedure is a minimally invasive procedure, there is almost no blood loss involved during the procedure.

What are the possible Risks and Complications during the Epidural Injections radiology procedure?

Following are the possible risks of Epidural Injections:

• Hot flashes may happen due to the medication reaction
• The injection may damage the nerves
• Bleeding
• Headache
• Some patients may experience temporary worsening of pain right after the procedure, which eventually gets better
• Spinal cord injury, stroke, or possible death, if the needle is placed incorrectly 

What Post-Operative Care is needed at the Healthcare Facility after the Epidural Injections radiology procedure?

• Generally, no significant post-operative care is needed at the healthcare facility, unless any complications are observed
• However, a short period of observation may be occasionally recommended by your healthcare provider

After the Epidural Injections radiology procedure:

What is to be expected after the Epidural Injections radiology procedure?

After the administration of Epidural Injections, the following may occur:

• After the procedure, patient may feel some discomfort or numbness which should resolves in few hours
• The patient may resume their normal activities the next day, after the procedure
• Improvements are usually noted progressively, 48 hours after the procedure
• Temporary bladder or bowel dysfunction may occur, due to nerve paralysis
• Infection at the injection site may occur

When do you need to call your Physician?

Do inform your healthcare provider:

• If there is significant pain after the procedure, or the pain worsens after the procedure and does not resolve
• If you experience any fever or chills
• If any other complications are noted

What Post-Operative Care is needed at Home after the Epidural Injections radiology procedure?

No specific post-operative care is needed at home after the procedure.

How long does it normally take to fully recover, from the Procedure?

The recovery time depends on the reason for administering the injection. However, in most cases, the patient may resume their normal activities a day after the procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The procedure does not involve the removal of any body tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Epidural Injections radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before Epidural Injections are administered.