The term “thoracic transforaminal epidural steroid injection” sounds a bit intimidating, as most clinical terminology can. When broken down into its individual terms however, this “complicated-sounding” procedure becomes a bit easier to understand.
- Thoracic – Thoracic refers to the upper and middle section of the back. The thoracic spine is composed of twelve vertebrae and plays an important role in stability and providing protection for vital organs in the chest. The thoracic spine has a relatively solid construction and its vertebrae do not rotate as much as those in the neck and low back, making it generally less susceptible to injury. However, this is not to say that the thoracic spine is not prone to problems. The upper back is still susceptible to muscular problems, joint dysfunction, degenerated or herniated discs, arthritis, vertebral fractures and other spinal conditions.
- Transforaminal – The term transforaminal means “through an opening,” and in this case, through the foramen. During a thoracic transforaminal ESI, the needle is guided through the foramen – the opening where the spinal nerve exits at the level where the nerve or disc injury has occurred.
- Epidural – The epidural space is the area between the dura mater (a membrane) and the vertebral wall. It is the outermost section of the spinal canal and contains nerve roots, blood vessels and fat tissue. During a thoracic transforaminal ESI, medicine is injected into the epidural space, directly over the compressed nerve root.
- Steroid – Steroids (short for corticosteroids) are a type of medication that closely resembles cortisol, a hormone that your body produces naturally. Medications of this class powerfully reduce inflammation.
Thoracic Transforaminal ESI Procedure
A thoracic transforaminal epidural steroid injection is a minimally invasive outpatient procedure. The treatment is performed with the patient lying on their stomach. Prior to injecting the medication, the patient’s skin is numbed with a local anesthetic to diminish pain from the injection.
Next, using real time x-ray (fluoroscopy), the needle is carefully guided into place. A contrast dye is first injected to ensure the flow is to the target location. Once proper needle placement is confirmed, a mixture of local anesthetic and the steroid medication will then be administered.
After the procedure is completed, a small bandage is placed on the injection site. The patient is then monitored for a short period of time before being discharged home. Patients often notice immediate relief from their painful symptoms. This is due to the local anesthetic that is injected with the steroid medication. The steroid itself will typically begin providing more sustained pain relief by the fifth day following the procedure. However, this varies from patient to patient and you may notice pain relief starting sooner.
Schedule an Appointment to Discuss Upper and Mid Back Pain
If you are experiencing pain, numbness or tingling sensations in the upper or middle back region, then you may benefit from thoracic transforaminal epidural steroid injections. Call the Diagnostic Pain Center in Austin at (512) 981-7246 or click on the button below to request an appointment.