Lumbar Epidural Steroid Injection

The epidural space is the area between the dura (covering of the spinal cord) and ligaments that connect the vertebrae. Injecting steroid into this area can help symptoms associated with spinal stenosis, spondylolysis, disc degeneration or disc herniation. The epidural injection delivers a longlasting steroid and an anesthetic agent to the irritated and inflamed area or nerve. Injection often allows patients to resume a more normal activity level.    Epidural Steroid Injection

Midline or Translaminar Injection

This approach is used for treatment of multiple inflamed nerves or segments. The needle is placed between the lamina of two vertebrae. This allows medication to spread up and down as well as to both sides within the epidural space. This method is helpful when the exact pathology is not known or when multiple areas of pathology exist.    Midline or Translaminar Steroid Injection

Transforaminal Epidural or Selective Nerve Root Block

These routes are preferred when there is a clearly identified area of pathology or the response to an injection is needed to diagnose the affected area (selective nerve root block). They may also be helpful when the translaminar route fails to give an adequate result or when surgery has changed the anatomy making the translaminar route infeasible. The needle is placed to the side of the vertebra near the hole (foramen) of the affected spinal nerve. Contrast dye is used to identify the outlining of the nerve.    Transforaminal Epidural or Selective Nerve Root Block Pain Treatment

Pre Injection Instructions

If you are anxious about your procedure, sedation can be provided. If you choose this option you must meet the following criteria:

  • Come to your appointment with a responsible adult driver
  • Fast for at least 6-8 hours prior to our appointment time. Morning medications can be taken with a sip of water no later than 2 hours prior to you appointment time. Exceptions may include diabetic medications, in this case please call the office for specific instructions
  • If you are taking blood thinners or supplements, we may ask that you discontinue them prior to your procedure. Never stop these medications without approval from the physician prescribing them.

Here is a short list of blood thinners and the amount of days they should be discontinued prior to your procedure:

Acenocoumarol 3 days
Agggrenox 7 days
Aggrastat 24 hours
Arixtra 4 days
Asprin 7 days
Brillinta 7 days
Edoxaparin 2 days
Efflent 7 days
Eliquis 3 days
Heparin 8 hours
Integrillin 24 hours
Lovenox 12 hours
Pentoxil  2 days
Plavix  7 days
Pletal  7 days
Pradaxa  6 days
ReoPro  3 days
Ticlid  14 days
Warfarin/Coumadin  5 days
Xarelto 3 days

Please call our office if your blood thinner is not listed.

If you are taking any supplements such as Fish Oil, Garlic, Ginseng, Vitamin A&E, Ginger, Kava Kava, Clove, White Willow bark, or Gingko please stop these 7 days prior to your procedure.

1055 Bowles Ave.
Ste 202
Fenton, MO 63026
Phone (636) 326-7821
Fax (636) 326-7897
  St. Peters
4800 Mexico Rd, Ste. 101,
St. Peters, MO 63376
Phone (636) 442-5035
Fax (636) 442-5036
1601 Wentzville Pkwy
Suite 101
Phone (636) 332-8902
Fax (636) 332-8904

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