Spinal injections are used for a variety of conditions in both the neck (cervical spine) and lower back (lumbar spine). They can be used to confirm an accurate diagnosis as well as for treatment of pain that is not being adequately controlled despite appropriate non-surgical treatments. Often the injection is used for both diagnosis and treatment of pain in combination.
Injections will typically include a combination of an anti-inflammatory (cortisone) medication, and a fast-acting analgesic (local anaesthetic). The local anaesthetic will work quickly but also wears off after a short period of time, and this is used to determine if the source of pain has been diagnosed correctly. The cortisone acts more slowly and helps to alleviate the pain for a longer period of time.
Injections are performed by an interventional radiologist who has undergone training specific to spinal injections. A CT scan is used to guide the injection into the correct level, as well as into the correct location at that level. An image is saved confirming the correct location but also as a guide for future reference if needed.
This injection is placed into the epidural space surrounding the thecal sac that contains the spinal nerve roots. This does not target a particular nerve root, rather the whole level that is being treated.
A nerve root injection is a more targeted injection that is placed near the isolated nerve root once it has already exited the thecal sac. This injection is commonly used for a disc prolapse causing radicular pain down into one leg or arm.
These injections are placed around the facet joint, and are targeted at the small nerves that supply sensation to the arthritic joint. This is often helpful for a prolonged period, but if it only gives short term relief there are other options for treatment (see facet joint arthritis)