What is interlaminar epidural steroid injection?
Back discomfort caused by sciatica, herniated discs, misplaced vertebrae, or other back disorders can be alleviated with an interlaminar injection.
Your legs and arms are connected to your spinal cord via nerves. Your back, leg, neck, and arm can all feel the effects of an irritated and inflamed nerve “root” (the part of the nerve nearest to the spinal cord).
Taking a steroid prescription can help reduce inflammation and alleviate discomfort. It’s injected into the space between the spine and the spinal cord in the back of your body.
How does the interlaminar injection work?
An antibacterial cleaner will be used to scrub your back as you lie face down on an X-ray table for the process. An X-ray camera will be used by your doctor to pinpoint the injection sites. To reach your epidural space, a tiny needle is inserted between your spine’s vertebrae using a local anesthetic. Contrast dye is used to ensure that the medication—a mixture of saline and steroid—is administered in the precise location.
Steroids start working in two to three days after the surgery, which often takes less than 15 minutes. Every patient’s experience with pain treatment differs, but for some, alleviation might endure for months.
What is the procedure of the injection?
The following are the steps involved in administering an epidural injection:
- An IV is set up so that medication can be administered if necessary.
- On an X-ray table, the patient’s skin is thoroughly cleansed with an antiseptic.
- A local anesthetic is used to numb the area where the epidural syringe will be inserted.
- Doctors will utilize fluoroscopy (a supervised X-ray process where they can see the needle’s location and movement) in order to insert a tiny needle into the epidural area. At this point, the patient is likely to feel some discomfort. To make sure the drugs are placed correctly, fluoroscopy is a vital part of this surgery.
- For further assurance that the medication has reached any afflicted epidural nerves, it is necessary to inject a contrast dye.
- An anesthetic and a time-released anti-inflammatory steroid are injected together to provide numbing and anti-inflammatory effects.
The surgery itself typically lasts 30 minutes, with a 45-minute recuperation period in the clinic thereafter. Epidural injections necessitate an absence from driving. Epidural steroid injections necessitate a day of complete rest and no intense activity.
Is an Interlaminar steroid injection effective?
A few hours after the injection, the anesthesia wears off, and some patients notice relief within 30 minutes. To get long-term relief, the steroid should begin working within two or three days.
Each patient’s experience with pain alleviation differs in terms of how long it lasts. For some, the relief lasts for months or even years. Periodic injections may be necessary to maintain pain-free status if the treatment is effective for you.
Transforaminal vs interlaminar epidural steroid injection
Transforaminal epidural injections are becoming more popular among pain specialists because they allow them to more precisely target inflamed spinal nerve roots. Unlike interlaminar epidural injections, transforaminal epidural injections require fluoroscopic guidance and can be performed at more than one stage in a single treatment. They are therefore more difficult to perform.
It is possible that transforaminal epidural injections can be more effective, but they may also be more painful than interlaminar injections.
Interlaminar epidural steroid injection side effects
There are extremely few hazards associated with this surgery. In any case, there are some dangers and side effects to be aware of, just as with any other technique.
Most common adverse effects include an increase in pain after the injection, a puncture of the “sack” carrying spinal fluid (which can cause headaches), infection, hemorrhage or nerve damage.
Temporary side effects of steroid injections include sweating and redness of the face, weight gain, and a spike in blood glucose (mainly in diabetics) The steroid medication can be discussed in greater detail when you arrive in for the operation with your doctor, who may advise you to change your diabetes medication. For a few days later, flushing, perspiration, and/or palpitations are common side effects.
Blood vessel damage
The soft tissues, epidural space, or spinal cord membranes may bleed and pool blood if an artery is damaged. Blood flow to the brain and spinal cord can be cut off by a blood clot or hematoma forming in the artery. 4
Nerve injury
Seizures and strange sensations might be caused by damage to nearby nerves. Cauda equina syndrome is a medical emergency caused by injury to the cauda equina nerves at the root of the spinal cord. Treatment for this syndrome, which results in loss of control over bowel and bladder function, should be sought as soon as possible in order to avoid lower-body paralysis.