Translaminar Epidural Steroid Injections

Epidural steroid injections are another modality we use for back pain. We typically use this for more of what we call radicular pain or nerve root pain, and in colloquial terms we talk about that as a pinched nerve. And so, we treat that a little bit differently than we would do a mechanical or axial pain because we are actually trying to treat the nerve root. For patients with spinal stenosis or we are trying to treat an area of the nerve that is being compressed, we can do a translaminar epidural steroid injection. This is pretty commonly known in circles like OB-GYN, that’s what women get for pregnancy. That’s a translaminar approach, we go from the middle of the back, through the ligaments into the epidural space and apply the steroids and local anesthetic in that area, so it’s more of a midline approach. This is a little different than a transforaminal approach which is mostly targeting the dorsal root ganglion; we’re looking mostly for pain relief, specifically to a pinched nerve either in the left leg or the right leg, so we go through the foramen. So it’s more of a paramedian approach, if you will, we are going through the foramen to where the dorsal root ganglion lives and applying the same medications again, steroids and local anesthetics.