J Korean Med Assoc.  2014 Apr;57(4):318-325. 10.5124/jkma.2014.57.4.318.

Epidural steroid injection

• Kim SK
• Chung JY

• KMID: 2064889
• DOI: http://doi.org/10.5124/jkma.2014.57.4.318

Abstract

Excessive spine operations is an economic and social problem today in Korea. Proper conservative treatment can reduce the need for surgical treatment by relieving the pain during the acute phase of spinal disease. Epidural steroid injection and a selective nerve root block are relatively safer and easier than other treatments. They may have many advantages such as relief of neck and back pain and of radicular pain, and reducing the gastrointestinal adverse effects caused by long-term NSAID medication or injection. Furthermore, patients in an inoperable state due to old age or other comorbidities and outpatients who want conservative treatment may benefit from epidural steroid injection and a nerve root block. The treatment outcomes differ among reports. The efficacy of temporary pain relief has been described to be excellent, but it gradually decreases as time passes. Recently, transforaminal epidural steroid injection has been widely performed. Epidural steroid injection should be performed for temporary pain relief due to its limited efficacy. In addition, an overuse of epidural and selective nerve root steroid injection can cause serious side effects. Therefore, this procedure should be done with caution, taking into account the technical risks and side effects.

Keyword

Spine; Pain management; Epidural injections; Nerve block; Steroids

MeSH Terms

Back Pain
Comorbidity
Humans
Injections, Epidural
Korea
Neck
Nerve Block
Outpatients
Pain Management
Social Problems
Spinal Diseases
Spine
Steroids
Steroids

Figure

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  Figure 1 A 33-year-old man with disc herniation at L3-4. (A) Anterior-posterior radiograph of the lumbar spine following transforaminal epidural block (after contrast injection). The needle tip lies directly inferior to the pedicle and contrast extends to the left epidural space. (B) Lateral radiograph. The contrast extends to the anterior epidural space.

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