Thoracic Interlaminar Procedure
What is the Epidural space?
The duramater is a protective covering of the spinal cord and its nerves. The space surrounding the duramater is called the epidural space. In the thoracic area, it is called the thoracic epidural space.
Causes pain in the Epidural space
The thoracic area of the spine has twelve bones, called vertebrae. Soft discs found between them cushion them, hold them together, and control motion. If a disc tears, chemicals inside may leak out. This can inflame the duramater or nerve roots and cause pain. A large disc tear may cause a disc to bulge, inflaming the duramater and nerve roots, and cause pain. Bone spurs, called osteophytes, can also press against nerve roots and cause pain.
You may be given oral Valium or IV (intravenous) medication to help you relax. You may lie down with face down on the procedure table. The thoracic spine is identified under fluoroscopy (a type of X-ray is used to ensure the safe and proper position of the needle). A local anesthetic is used to numb your skin. Then an Epidural needle is inserted into the spine. The needle is advanced until it reaches the epidural space. Then medication is injected into the epidural space of the spine next to the lumbar spinal cord and exiting nerve(s) that are the likely cause of your pain in mid back, flank or chest.
Why is a Thoracic Epidural Steroid Injection Procedure helpful?
It is helpful in the diagnosis and treatment of your mid back and/or chest pain, which is likely due to a disorder of your thoracic spinal cord and exiting nerve(s). Medications used for the injection: a local anesthetic and a long-acting anti-inflammatory steroid agent. At first, you may or may not experience temporary pain relief after the injection. Then, after 48 to 72 hours, you will likely experience pain relief after the injection due to the effects of the long anti-inflammatory steroid agent.
You will be observed for at least 10-15 minutes in the recovery room for your response to the injection. Your oxygen level, blood pressure, pulse rate, and respiratory rate will be monitored in the recovery room. You may become a little sore at the soft tissues of the procedure site, which is normal and to be expected. You may apply an ice-pack to the sore area of the procedure site. The soreness at the procedure site should go away in a couple of days. It usually takes 48 to 72 hours to experience relief from the long-acting anti-inflammatory steroid agent. A follow-up appointment will be made for you.
When can I go to work after a Thoracic Epidural Steroid Injection Procedure?
You can return to work the next day.
How long can I expect pain relief?
Depending on the amount of inflammation, an injection could offer pain relief for a few weeks to a few months. For some, a single injection could result in long-term pain relief. If your pain is caused by injury to more than one area, only some of your symptoms will be helped by a single injection. The epidural injection may need to be repeated 3-4 times after a few weeks or months depending on individual’s pain.