CERVICAL EPIDURAL INJECTION
What is the epidural space?
The membrane that covers the spinal cord and nerve roots in your neck is called
the dura membrane. The space surrounding the dura is epidural space in your
neck. Inflammation of the nerve roots in the neck may cause pain in the arms
and shoulders due to irritation from a damaged disc or from contact with the
bony structure of the spine in some way.
What is an epidural and why is it helpful?
An epidural injection places anti-inflammatory medicine into the epidural space
to decrease inflammation of the nerve roots, hopefully reducing the pain in
your neck, shoulders, and arms. The epidural injection may help the injury to
heal by reducing inflammation. It may provide permanent relief or provide a
period of pain relief for several months while the injury/cause of your pain
is healing.
What will happen to me during the procedure?
An IV will be started so that relaxation medication can be given. Depending
on your physician's preference, you will be placed in a prone position or sitting in a chair, positioned in such a way that your doctor can best
visualize your neck using x-ray guidance. The skin on the back of your neck
will be scrubbed using two types of sterile scrub (soap). Next, the physician
may numb a small area of skin with numbing medicine. This medicine stings for
several seconds. After the numbing medicine has been given time to be effective,
your doctor will direct a small needle using x-ray guidance into the epidural
space. A small amount of contrast (dye) is then injected to insure proper needle
position in the epidural space. Then, a small mixture of numbing medicine (anesthetic)
and anti-inflammatory (cortisone/steroid) will be injected.
What will happen after the procedure?
You will go back to the recovery area where you will be monitored for 30 -
60 minutes. You will then record the relief you experience during the next week
on a post injection evaluation sheet ("pain diary"). This will be
given to you when you are released to go home. You will also be given a follow-up
appointment for a repeat block if indicated. These injections are usually done
in a series of three (3), about two (2) weeks apart. PLEASE return this completed
pain diary to NeuroCare Network and our office will contact you if it is necessary
to change your next appointment.
You will not be able to drive the day of your procedure. Your arm may feel
weak or numb for a few hours.
General Pre/Post Instructions
You should eat a light meal within a few hours before the procedure. If you
are an insulin dependent diabetic, do not change your normal eating pattern
prior to the procedure. Please take your routine medications (i.e. high blood
pressure and diabetic medications). If you are on Coumadin, Heparin, Plavix,
or any other blood thinners (including aspirin), or the diabetic medication
Glucophage, you must notify the office so the timing of these medications can
be explained.
You will either be at one of the hospitals or at the NeuroCare Network facility
approximately 2 - 3 hours for your procedure. You will need to bring a driver
with you.
You may return to your normal activities the day after the procedure, including
returning to work.
Location of Procedures:
Texas Spine & Joint Hospital - Roseland Boulevard
Northpark Medical Plaza - 910 E. Houston (across from Mother Frances Hospital)
East Texas Medical Center Hospital - 1000 S. Beckham
If your are unable to keep this appointment, please give notice as soon
as possible and at least 24 hours in advance by calling (903) 597-3472 and
ask for the person who schedules your doctor's Special Procedures. Thank you.
