Medical Media Images

Cervical Transforaminal Epidural Steroid Injection

What does “Cervical Transforaminal Epidural Steroid Injection” mean?

Here is an explanation of each word:

  1. Cervical: the parts of the spine located in the neck
  2. Transforaminal: through a foramen (the opening for the spinal nerve to leave the spine and travel to the arm)
  3. Epidural: a space outside of the lining of the spinal cord, spinal fluid and spinal nerves
  4. Steroid: a powerful anti-inflammatory medication sometimes called “cortisone”

Altogether, “Cervical Transforaminal Epidural Steroid Injection” means injecting a strong anti-inflammatory medication around a spinal nerve in the neck at the point where the nerve leaves the spine.

Why is a Cervical Transforaminal Epidural Steroid Injection done?

A cervical transforaminal epidural steroid injection is a procedure often done as a treatment for pain stemming from disc herniations in the neck. The disc herniation often results in inflammation the spinal nerve next to it, resulting in neck and arm pain. This inflammation is the target of the procedure.                              

Another reason for the procedure is narrowing of the opening in the vertebra through which the spinal nerve travels (foramen).

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 Transforaminal Epidural Steroid Injection done?

Here are some of the steps of how a Cervical Transforaminal 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) either by mouth or with an intravenous catheter (IV).
  3. The patient is usually placed on the back (supine), with the head turned away from the painful side.
  4. The side 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 (spinal or procedure needle) is inserted through the anesthetized area.
  7. At this point, an X-Ray machine is typically used to see the tip of the needle as it is slowly advanced towards the foramen (hole for the spinal nerve).
  8. When the needle tip appears to be in a good position close to or barely in the foramen, 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, and a local anesthetic.
  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 this procedure?

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

How much relief can patients gain from a Cervical Transforaminal 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.