The purpose of an epidural lumbar infiltration
Back pain (see categories below) is currently the leading cause of work incapacity. Half of the Swiss population suffers from it several times a week or month. These pains are usually accompanied by stiffness and are most often predominately on one side of the back. However, the pain can radiate into the lower limbs – the legs – and especially along the sciatic nerve path.
Some people find relief with the usual treatments such as medication and physiotherapy, while others have more difficulty. Following an imaging assessment (preferably an MRI), the epidural lumbar infiltration comes into play, using the transfacet approach under CT guidance. The epidural route is especially preferred for a medial hernia and narrow lumbar canal.
It provides pain relief when conventional treatments fail.
Here is everything you need to know about this radiological procedure.
What is an epidural lumbar infiltration using the transfacet approach?
A spinal infiltration is an injection of a cortisone-based anti-inflammatory at the spinal column level. It is frequently used to reduce localised inflammation and thus relieve persistent lumbar and sciatic pain. The intra-canal infiltration is performed using the transfacet approach.
The articular masses are small joints located at the back of each vertebra and thus enable them to pivot. Being an anatomical area that is particularly stressed, lower back pain and sciatic nerve pain are the most frequently encountered pains. They originate mainly from conditions that can be grouped into three categories:
Mechanical problems
- Injury to one of the discs located between the vertebrae
- Osteoarthritis, arthritis and osteoporosis
- Vertebral malformation
- Overweight
- Herniated disc
Back trauma
- Vertebra fracture
- Vertebral compaction
Inflammatory or infection problems
- Inflammation of the vertebral joints
- Arthritis (in the case of osteoarthritis or chronic inflammatory disease)
Why perform this medical procedure in the radiology department?
This technical radiological procedure is performed between the facet joints that connect two vertebrae. To perform it with precision and continuously monitor the position and path of the needle, it is performed under CT (computed tomography) guidance. This CT will enable radiologists to look at the tissues of the human body that have different densities, by providing images in thin sections on three planes.
This means that they will be able to carefully inject the therapeutic substance into the painful area.
How an epidural lumbar infiltration is performed under CT guidance
The epidural lumbar infiltration is an outpatient procedure. You will lie flat on your stomach on an examination table in the CT room, where the procedure will be explained to you. The radiologist, assisted by a technician, will prepare the equipment and carefully disinfect the lumbar region where the pain is located.
They then use the imaging to get their bearings and guide a very fine needle towards the relevant region and control the position of the needle with a few drops of contrast medium.
Finally, they administer the cortisone medication.
In general, the procedure only lasts about twenty minutes (including preparation) and, following a short observation period, you can return home, making sure that you don’t strain the treated area.
What are the advantages of this infiltration?
The epidural lumbar infiltration improves the quality of life of patients suffering from acute or chronic pain. The purpose of this procedure is to reduce inflammation in the area causing pain. It is a second-line, life-saving remedy that enables them to resume their daily activities or even sports depending on the instructions of the attending physician.
The effectiveness of this method can be seen within 10 days of administering the treatment. A check-up with the attending physician a certain period of time after the infiltration may be prudent in order to assess the success of the treatment.
Can an infiltration be repeated?
Treatment may require several infiltrations in the affected region, in accordance with your physician’s advice.
Are there any risks and/or complications linked to an epidural infiltration in the lumbar region?
Complications remain extremely rare as treatment is performed in a fully aseptic environment, with optimal guidance that adheres to the recommendations of the Swiss Society of Neuroradiology.
You will be offered a safety questionnaire to prevent the risk of allergies or bleeding (taking certain medications and/or anticoagulants).
At the Medimage medical centre, we are committed to developing infiltration procedures and techniques that effectively relieve patients of their pain.
Learn more about lumbar infiltration
If you would like more information on epidural lumbar infiltration or would like to make an appointment for an examination, do not hesitate to contact us.
Learn more about pudendal infiltration, extra-articular infiltration, osteoarticular infiltration, facet joint infiltrations, foraminal spinal infiltration or hyaluronic acid infiltrations.
Learn more about the other examinations available at the Medimage centre: radiography and radiology in Geneva, MRI in Geneva (Magnetic Resonance Imaging), CT scan, cardiac imaging, mammogram in Geneva, ultrasound in Geneva, elastography, biopsy in Geneva, infiltrations in Geneva, PRP infiltrations, dental panoramic or mineralometry.
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