Thoracic Transforaminal Epidural Steroid Injection

Overview This injection procedure relieves pain in the upper back, ribs, and abdomen caused by a pinched nerve (or nerves) in the thoracic spine.

Preparation The procedure is performed with the patient lying on the stomach. A region of skin and tissue of the back is numbed with an injection of local anesthetic.

Inserting the Needle The physician uses an x-ray device called a fluoroscope to guide a needle to the painful area of the spine. The needle is inserted into the neural foramen space, the region through which spinal nerves travel.

Confirming the Needle Placement Contrast dye is injected into the space to make sure the needle is properly positioned near the irritated nerve or nerves.

Injecting the Medication A combination of an anesthetic and cortisone steroid solution is injected into the foramen space. The steroid is an anti-inflammatory medication that is absorbed by the inflamed nerves to decrease swelling and relieve pressure.

Contrast Dye Injected The physician injects a contrast solution and uses the fluoroscope to confirm the correct position of the needle tip. Steroids Injected A steroid-anesthetics mix is injected into the foraminal epidural space, bathing the painful nerve root with soothing medication.

End of Procedure and After Care The needle is removed and a small bandage is applied. Extended pain relief usually begins within two to three days of the injection. Some patients may need only one injection, but two or three injections may be needed to provide significant pain relief.