Transforaminal steroid injections

In many cases, vertebral fractures can be treated through conservative methods such as bed rest, a back brace or pain medication. However, patients with osteoporosis or whose fractures have caused severe, long-term pain may benefit from a minimally invasive procedure such as vertebroplasty to relieve symptoms. This procedure is also recommended for patients who are too weak to undergo spinal surgery, or have a malignant tumor within the spine that has caused vertebral damage. Vertebroplasty is most effective when performed on fractures that are less than six months old.

The following patients should not have this injection: if you are allergic to any of the medications to be injected, if you are on a blood-thinning medication (. Coumadin, injectable Heparin), or if you have an active infection going on. With blood thinners like Coumadin, your doctor may advise you to stop this for 4-7 days beforehand or take “bridge therapy” with Lovenox prior to the procedures. Anti-platelet drugs like Plavix may have to be stopped for 5-10 days prior to the procedure. Aspirin should be stopped for cervical procedures for 10 days prior, but not for Lumbar.

The needle is smaller in size than that used during a conventional epidural approach. The procedure is performed with the patient lying on their belly using fluoroscopic (real-time x-ray) guidance, which helps to prevent damage to the nerve root. A radiopaque dye is injected to enhance the fluoroscopic images and to confirm that the needle is properly placed (See Figure 2). This technique allows the glucocorticoid medicine to be placed closer to the irritated nerve root than using conventional interlaminar epidural approach. The exposure to radiation is minimal.

Transforaminal steroid injections

transforaminal steroid injections

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