Thoracic Epidural Injections

What is a Thoracic Epidural Injection?

The dura is a fluid-filled sack that protects the brain, spinal cord, and nerves. The space around the dura is called the "epidural space." Anytime medicine is put into this space, it is called an "epidural." Epidural injection of anesthetic (painkiller) and steroid medications can be useful to diagnose or treat spine pain caused by injury or inflammation (swelling) of spine structures and spinal nerves. To ensure proper placement of the medication the procedure is done under fluoroscopy (a type of low dose X-ray).

What is the purpose of a Thoracic Epidural Injection?

Back pain is often due to injury or inflammation of the disc and other supporting structures. The nerves are very close to the discs and they can be irritated as well, causing pain down the arm. Steroid medication can reduce inflammation and pain from the disc, nerves, and other structures.

How is the procedure performed?

After you check-in, you will be asked to put on a hospital gown and then lie on a table in a procedure room. An IV may be started for medications and safety. Although you will be awake throughout the test you may be given medicine to allow you to relax and control your pain. After being positioned on the table, your skin will be cleaned with sterile soap. A local anesthetic (painkiller over the area being looked at) is injected to numb your skin and muscles. After this, fluoroscopy (X-ray) is used to guide a needle into the proper location, and then medication is slowly injected. After the test, you are taken to a recovery room where you'll need to rest for at least 30 minutes before going home.

The entire process for check-in, preparation, recovery, and checkout will take several hours. The procedure itself takes less than 15 minutes, however more time is spent in the procedure room for preparation. During the injection, pain is sometimes increased temporarily. The procedure can be stopped immediately at any time upon your request. Following the procedure you may experience some increased discomfort for about 2-3 days while the steroid medication is taking effect.

What are the risks associated with a Thoracic Epidural Injection?

Every medical procedure, no matter how small, contains some risks. Anytime a needle is placed into your body there is a risk of tissue injury, infection, and bleeding. If this occurs in or near the spine it can result in nerve damage. Although extremely rare, severe nerve damage and death have occurred following spine injections. Injections near the spine also risk puncturing the dura and possible headaches. More common risks include a temporary increase in pain, local tenderness after the injection, allergic reaction to medication, and side effects from steroids.