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Spinal injections for pain management
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We've answered common questions about recent news of meningitis among patients who were treated with steroid injections.
Pain management procedures fall into two categories - diagnostic and therapeutic.
For imaging, we use fluoroscopy, a type of low-dosage x-ray. Fluoroscopy allows us to clearly see the spinal area in real time, on a video monitor, so we can see exactly how the procedure is progressing.
All of these procedures use image-guided injections through a precisely placed, small needle.
A neuroradiologist or spine radiologist, a physician who has special training, expertise and experience in these areas does the procedures. Our radiologists have performed many of spinal injection procedures.
The procedures are done on an outpatient basis, and you'll have little restriction on eating or drinking before your appointment.
A small needle will be inserted in your back or neck into an area or part of your spine. Anesthetic, contrast agent and/or steroid preparation will be injected, depending on the procedure.
Anesthetic helps give immediate pain relief, the contrast agent helps confirm the precise location for the injection, and the steroid preparation may be effective in long term control of your symptomatic pain.
You must tell your doctor if you are or may be pregnant, have allergies, latex allergies or sensitivity, or are taking any "blood thinners" such as coumadin. Do not eat solid food three hours prior to the appointment.
Myelogram - A needle is placed into the fluid space around the nerves in your back. A contrast agent is injected to opacify the space and enhances the fluoroscopic display. X-ray images are obtained to look for spinal narrowing and/or nerve impingement.
Discogram - A needle is placed into the discs in your spine and contrast agent is injected to duplicate or elicit the pain symptoms you have been experiencing. You'll be asked to describe the pain to the examining radiologist.
Nerve Root Block - A needle is placed close to a nerve suspected of causing your pain symptoms. A small amount of anesthetic is injected to see if it reduces your pain symptoms.
Facet or sacroiliac joint injection - A needle is placed into a joint in your spine and a combination of anesthetic and steroid preparation will be injected to relieve your pain symptoms.
Epidural steroid injection - A needle is placed into the space surrounding the nerves in the spinal canal. The location of the needle is confirmed by injecting a small amount of contrast agent. A combination of local anesthetic and steroid preparation is injected for relief of your pain symptoms.
After your procedure, you will be observed for a short time and then you will need to have someone drive you home. Rarely, there could be bleeding, infection, neural injury, temporary numbness or facial flushing. You can resume normal activities the next day. You will be asked to complete and return an assessment log of your results so we can evaluate the effectiveness of the procedure. As with all medical procedures, spinal injections for pain management are not always effective.
Source: Mercy & Unity Hospitals, Diagnostic Imaging
Reviewed by: Jane Heyer, Supervisor, Radiology & Diagnostics and Deb Reinhart, Supervisor, Radiology - CT
First Published: 01/01/2005
Last Reviewed: 05/09/2006