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Cervical Interlaminar Epidural Steroid Injection

What does “Cervical Interlaminar Epidural Steroid” Injection mean?

Here is what each word means:

  1. Cervical: the parts of the spine located in the neck
  2. Interlaminar: between two laminar bones
  3. Epidural: a space above (closer to the skin) the lining (dura) of the spinal cord, spinal fluid and spinal nerves
  4. Steroid: a powerful anti-inflammatory medication sometimes called “cortisone”

Altogether, “Cervical Interlaminar Epidural Steroid Injection” means injecting an anti-inflammatory medication into a space above the spinal cord by placing a needle between the lamina bones of the neck.

Why is a Cervical Interlaminar Epidural Steroid Injection done?

  1. A cervical interlaminar epidural steroid injection is a procedure typically done as a treatment for pain stemming from disc herniations in the neck. The disc herniation often causes inflammation of the disc and the spinal nerve next to it. This inflammation and the pain it causes, are the target of this procedure.
  2. Another reason for a cervical interlaminar epidural steroid injection is spinal stenosis (narrowing of the canal in the spine). In spinal stenosis, the spinal canal is narrowed causing inflammation of the spinal nerves and the area around the spinal cord. Eliminating this inflammation is the goal of the injection.
  3. Sometimes cervical epidural steroid injections are done for general neck pain. In this case, the exact problem causing the inflammation may not be known.

What is the difference between a Cervical Interlaminar Epidural Steroid Injection, a Transforaminal Epidural Steroid Injection, and a Cervical Nerve Root Block?

All three injections are often done for inflamed spinal nerves in the neck, most commonly due to a disc herniation. The difference between these injections is where the medication is delivered. Some of this may depend on the location of a disc herniation or the preference of the doctor performing the injection.

Here is where each injection delivers the medication:

  1. Cervical Interlaminar Epidural Steroid Injection:

The medication is injected into the main epidural space on the back of the spine, just outside the spinal cord and its lining (dura). The medication usually spreads over a wide area, i.e. multiple spinal nerves and discs.

      2. Cervical Transforaminal Epidural Steroid Injection:

The medication is injected through the foramen (opening for the spinal nerve to leave the spine), i.e. right next to the inflamed nerve. The medication usually does not travel very far from the nerve.

      3. Cervical Nerve Root Block

This injection is very similar to the Cervical Transforaminal Epidural Steroid Injection. The difference is that the medication is placed next the nerve outside the foramen, i.e. once the nerve has left the spine.

How is a Cervical Interlaminar Epidural Steroid Injection done?

Here are some of the steps of how an Interlaminar Epidural Steroid Injection is done:

  1. The procedure is usually done in a Procedure Room or Operating Room.
  2. The patient may receive relaxing medication (sedation) with an intravenous catheter (IV).
  3. The patient is either placed on the stomach (prone) or kept in a sitting position.
  4. The back of the neck is cleaned with a surgical antiseptic and sheets (drapes) are used to keep the area clean.
  5. The doctor will then inject a small amount of a local anesthetic under the skin.
  6. Next, a specialized needle (epidural needle) is inserted through the anesthetized area.
  7. At this point, typically an X-Ray machine is used to see the tip of the needle as it is slowly advanced into the epidural space.
  8. When the needle tip is located in the epidural space, a small amount of contrast material (fluid which looks dark on an X-Ray) is injected through the needle to verify that it is in the correct location.
  9. Next, a mixture of medication is injected into the epidural space. This mixture may consist of a steroid, a local anesthetic, or a pain killer.
  10. The needle is withdrawn.
  11. A band-aid is placed at the site of the needle puncture.
  12. The patient is then taken to a Recovery Area for a period of observation.

How long does it take to do the procedure?

Typically a cervical interlaminar epidural steroid injection takes 5-10 minutes to complete.

How much relief can patients gain from a Cervical Interlaminar Epidural Steroid Injection?

The relief from spine injections can vary. If the injection is done for an inflamed spinal nerve, the relief can be substantial or complete. It could last for weeks to months.