PT  - JOURNAL ARTICLE
AU  - J.D. Bartleson
AU  - Timothy P. Maus
TI  - Diagnostic and therapeutic spinal interventions
AID  - 10.1212/CPJ.0000000000000043
DP  - 2014 Aug 01
TA  - Neurology: Clinical Practice
PG  - 347--352
VI  - 4
IP  - 4
4099  - http://cp.neurology.org/content/4/4/347.short
4100  - http://cp.neurology.org/content/4/4/347.full
AB  - Epidural injections of local anesthetic or a corticosteroid are frequently given to diagnose and treat patients with radicular pain originating from any spinal level. The best-quality evidence supports a transforaminal approach in the lumbar spine. Many patients experience substantial benefit from a single therapeutic injection. Depending upon the benefit obtained, additional injections may be administered. Selective nerve blocks with local anesthetic alone can identify the spinal nerve mediating the patient's pain. Serious short-term risks are rare but occur; long-term risks are infrequent and can be due to systemic effects of multiple corticosteroid injections. Patients who have failed conservative therapy or are not candidates for surgical intervention can be considered for epidural steroid injections to relieve their radicular pain temporarily.