Lumbar Transforaminal Epidural Steroid Injection

A lumbar transforaminal epidural steroid injection (TFESI) is an image guided, minimally invasive method of targeted drug therapy which is performed to relieve low back and radiating leg pain. Steroid medication can reduce the swelling and inflammation caused by conditions such as disc injuries or nerve injuries. This approach for an epidural is transforaminal, which means through the foramen (a foramen is an opening between the bones of the spine where the nerve roots exit to get to the rest of the body). The TFESI allows placement of the anti-inflammatory medications directly at the source of inflammation. This minimizes side effects when compared to oral medications and increases efficacy.

How is a Lumbar transforaminal epidural steroid injection performed?

Patient Positioning

The patient lies face down.

Tissue Anesthetized

A local anesthetic (typically lidocaine) is used to numb the skin and the anticipated needle path towards the foramen. Sometimes these injections are performed at a second level or on the other side of the spine to try and make sure we cover the area we feel is generating the pain.

Fluoroscopic Guidance

Using a fluoroscope for guidance (live x-ray guidance), the physician directs the needle to the selected foraminal space. A contrast solution is injected to assess for ideal location and safety. The physician uses the fluoroscope to confirm the correct location of the needle tip.

Steroids Injected

A steroid-anesthetics mix is injected into the epidural space, bathing the painful nerve root with soothing medication.

End of Procedure

The needle is removed and a small bandage is applied to cover the tiny needle surface wound.

How long does it take for the lumbar transforaminal epidural steroid injection to work?

Most people feel some benefit from the injection between 3-7 days, however it can take up to two weeks before we see the full results.

Who performs a lumbar transforaminal epidural steroid injection?

Lumbar transforaminal epidural steroid injections are performed by one of the board certified interventionalists at Spine & Nerve Diagnostic Center (SNDC). Our interventionalists have performed thousands of these procedures.

Where are lumbar epidural steroid injections performed?

Lumbar transforaminal epidural steroid injections are typically performed at our state of the art SNDC procedure suites.