- Post-Procedure: Interlaminar Approach
- Post-Procedure: Transforaminal Approach
- Post-Procedure: Caudal Approach
Post-Procedure: Interlaminar Approach
POST-PROCEDURE CARE
- Complete pain scale assessment.
- Monitor 30-60 minutes.
- Do not drive home.
- Avoid exertional activity for 24 hours.
COMPLICATIONS
- Vasovagal reaction
- Dural puncture
- Postdural puncture (positional) headaches
- Headache without dural puncture
- Epidural abscess
- Epidural hematoma
- Durocutaneous fistula formation
- Cushing's syndrome
- Facial flushing
- Insomnia
- Low-grade fever
- Transient back or lower extremity pain
ANALYSIS OF RESULTS
More than 40 mostly uncontrolled studies on more than 4000 patients have been published on the efficacy of cervical and lumbar epidural steroid injections, which generally indicate that there is strong support for short term efficacy but limited long-term benefit.
OUTCOMES AND EVIDENCE
- Kepes and Duncalf: 60% effectiveness.
- White, Derby, and Wynne: success rate of 75%
- Botwin et al: 65% with significant improvement at 6 weeks post-injection, 62% at 6 months, and 54% at 12 months.
- Ackerman and Ahmad: 83.3% in the transforaminal group had at least partial pain relief, compared to 56.6% in the caudal group and 60% in the interlaminar group.
Procedure: Interlaminar Approach
Post-Procedure: Transforaminal Approach
POST-PROCEDURE CARE
- Complete pain scale assessment.
- Monitor 30-60 minutes.
- Do not drive home.
- Avoid exertional activity for 24 hours.
COMPLICATIONS
- Vasovagal reaction
- Dural puncture
- Postdural puncture (positional) headaches
- Headache without dural puncture
- Epidural abscess
- Epidural hematoma
- Durocutaneous fistula formation
- Cushing's syndrome
- Facial flushing
- Insomnia
- Low-grade fever
- Transient back or lower extremity pain
ANALYSIS OF RESULTS
More than 40 mostly uncontrolled studies on more than 4000 patients have been published on the efficacy of cervical and lumbar epidural steroid injections, which generally indicate that there is strong support for short term efficacy but limited long-term benefit.
OUTCOMES AND EVIDENCE
- Kepes and Duncalf: 60% effectiveness.
- White, Derby, and Wynne: success rate of 75%
- Botwin et al: 65% with significant improvement at 6 weeks post-injection, 62% at 6 months, and 54% at 12 months.
- Ackerman and Ahmad: 83.3% in the transforaminal group had at least partial pain relief, compared to 56.6% in the caudal group and 60% in the interlaminar group.
Procedure: Transforaminal Approach
Post-Procedure: Caudal Approach
POST-PROCEDURE CARE
- Complete pain scale assessment.
- Monitor 30-60 minutes.
- Do not drive home.
- Avoid exertional activity for 24 hours.
COMPLICATIONS
- Vasovagal reaction
- Dural puncture
- Postdural puncture (positional) headaches
- Headache without dural puncture
- Epidural abscess
- Epidural hematoma
- Durocutaneous fistula formation
- Cushing's syndrome
- Facial flushing
- Insomnia
- Low-grade fever
- Transient back or lower extremity pain
ANALYSIS OF RESULTS
More than 40 mostly uncontrolled studies on more than 4000 patients have been published on the efficacy of cervical and lumbar epidural steroid injections, which generally indicate that there is strong support for short term efficacy but limited long-term benefit.
OUTCOMES AND EVIDENCE
- Kepes and Duncalf: 60% effectiveness.
- White, Derby, and Wynne: success rate of 75%
- Botwin et al: 65% with significant improvement at 6 weeks post-injection, 62% at 6 months, and 54% at 12 months.
- Ackerman and Ahmad: 83.3% in the transforaminal group had at least partial pain relief, compared to 56.6% in the caudal group and 60% in the interlaminar group.
Procedure: Caudal Approach