The indications for this procedure are the same for a regular epidural steroid injection with some caveats. This approach to
the epidural space is more successful in patients with previous back surgery, or patients that experience radiating pain as
opposed to axial pain. It can also be used in a bilateral approach in cases where the medication will need to reach the anterior
part of the epidural space. With minimal modification, this procedure can also be used a diagnostic tool.
The patient will be placed in a prone (face down) position, and using live X-ray in an oblique manner; the nerve root exit point
(foramen) will be visualized. After numbing the skin over the area, a needle will be directed towards the desired location under
fluoroscopic guidance. Before injection the prepared solution the correct position of the needle will be verified using contrast
solution.
The procedure lasts about 20-30 minutes. After the completion of the procedure, Band-Aids will be placed at the injection
sites, and a nurse will monitor the blood pressure and pulse and will review the discharge instructions with the patient before
going home.
