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Lumbar Interlaminar Epidural Steroid Injection

What does Lumbar Interlaminar Epidural Steroid Injection mean?

Here is what each word means:

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

Altogether, “Lumbar Interlaminar Epidural Steroid Injection” means to inject an anti-inflammatory medication into a space above the spinal cord by placing a needle between the lamina bones of the low back.

Why is a Lumbar Interlaminar Epidural Steroid Injection done?

  1. A Lumbar Interlaminar Epidural Steroid Injection is a procedure often done as a treatment for pain from disc herniations in the low back. The disc herniation typically causes inflammation of the disc and the spinal nerve next to it. This can cause low back and leg pain (sciatica). The inflammation and the pain it causes, are the target of this procedure. The steroid can relieve the inflammation.
  2. Another reason for a Lumbar 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. Relieving this inflammation is the goal of the injection.
  3. Sometimes Lumbar Epidural Steroid Injections are done for general low back pain. In this instance, the exact cause or location of the inflammation may not be known.

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

All three injections are often done for an inflamed spinal nerve in the low back, usually due to a disc herniation. The difference between them is where the medication is injected. Some of this may depend on the location of the disc herniation or the preference of the doctor performing the injection. One type is not necessarily better than another.

Here is where each injection delivers the medication:

  1. Lumbar 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. Lumbar Transforaminal Epidural Steroid Injection:

The injection is done from around the side of the spine. The medication is injected through the foramen (opening for the spinal nerve to leave the spine and travel to the leg) and follows the spinal nerve back into the spine. The injection is done for a specific spinal nerve.

      3. Lumbar Nerve Root Block

This injection is very similar to the Lumbar Transforaminal Epidural Steroid Injection. The difference is that the medication is injected outside of the foramen (opening for the spinal nerve to leave the spine and travel to the leg) and follows the nerve away from the spine, rather than back into the spine. The injection is done for a specific spinal nerve.

How is a Lumbar Interlaminar Epidural Steroid Injection done?

Here are the steps of how a Lumbar 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 placed on the stomach (prone).
  4. The low-back (lumbar spine) 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 placed 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. Some doctors chose to perform this procedure without an X-Ray machine.
  8. When the needle tip appears to be 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.
  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 Lumbar Interlaminar Epidural Steroid injection takes 5-10 minutes to perform.

How much relief can patients gain from a Lumbar 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.