Lumbar Transforaminal Epidural Steroid Injection

Lumbar epidural steroid injections are an important treatment tool in the management of low back pain, particularly when accompanied by radiating leg pain, numbness or tingling.  The injected steroid can relieve inflammation around affected nerve roots or disc structures and can improve local blood supply and nerve function.

Injection therapy is designed to relieve pain to enable patients to increase their activity level and return to normal activities through a program of therapeutic exercise.

The procedure involves insertion of a spinal needle through the skin and deeper soft tissues of the back into the epidural space.  The injection is performed with the use of an x-ray device, called a fluoroscope, which provides constant monitoring of needle position to aid precise placement of the needle into the epidural space.  This space is located between the outer bony rim of the spinal canal and the thecal sac that holds the spinal cord and nerve roots in the center of the spine.  Most epidural injections are completed below the point at which the spinal cord ends.

Lumbar epidural steroid injections can be completed through a number of different anatomical approaches.  The video above demonstrates the procedure for transforaminal epidural steroid injection.