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Thoracic Interlaminar Epidural Steroid Injection

What does Thoracic Interlaminar Epidural Steroid Injection mean?

Here is what each word means:

  1. Thoracic: the parts of the spine located in the mid-back
  2. Interlaminar: between two laminar bones
  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, “Thoracic Interlaminar Epidural Steroid Injection means placing an injection of a powerful anti-inflammatory medication between two lamina bones in the mid-spine.

Why is a Thoracic Interlaminar Epidural Steroid Injection done?

  1. A Thoracic Interlaminar Epidural Steroid Injection is a procedure typically done as a treatment for pain stemming from disc herniations in the mid-back. The disc herniation often results in inflammation of the disc and the spinal nerve next to it. The injection targets the inflammation and the pain it causes.
  2. Another reason for a Thoracic 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. The goal of the injection is reduce this inflammation.
  3. Sometimes Thoracic Epidural Steroid Injections are done for mid-back pain. The exact problem causing the pain may not be known. The injection is done in hopes of reaching the area which is causing inflammation and pain.

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

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

Here is where each injection delivers the medication:

  1. Thoracic 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. Thoracic Transforaminal Epidural Steroid Injection:

The medication is injected through the foramen (opening for the spinal nerve to exit from the spine), i.e. right next to the inflamed nerve. The medication usually stays around the nerve inside the spine.

      3. Thoracic Nerve Root Block

This injection is very similar to the Thoracic Transforaminal Epidural Steroid Injection. The difference is that the medication is placed onto the nerve outside the foramen, i.e. outside the spine.

How is a Thoracic Interlaminar Epidural Steroid Injection done?

Here are the steps of how a Thoracic 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) either by mouth or with an intravenous catheter (IV).
  3. The patient is placed on the stomach (prone).
  4. The back of the mid-back (thoracic 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.
  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, a pain killer or a combination of these medications.
  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 Thoracic Interlaminar Epidural Steroid injection takes about 5-10 minutes to complete.

What benefit can patients gain from a Thoracic 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 can last as long as 3-6 months.