 Lumbar radicular pain (in the past referred to

as sciatica) and lumbar radiculopathy are

problems frequently encountered by the
interventional pain physician. These entities
result from inflammation and irritation of the
spinal nerves and the dorsal root ganglion

Steroid Injection
Transforaminal
The primary indication for transforaminal
epidural steroid injection is radicular pain
resulting from irritation and inflammation of
the dorsal root ganglion and other neural
tructures in its vicinity.
 significant bleeding diathesis
 systemic or local infections at the procedure
site
 mental state making communication difficult
including heavy sedation, and patients who
are uncooperative.
 Stopping anticoagulation medications should be
coordinated with the prescribing physician.
 Informed consent
 the rostral and ventral portion, of the
intervertebral foramen Recently, a
“retroneural” approach has been described
which results in the needle tip being placed
subpedicular, but in the mid-foramen slightly
dorsal to the segmental nerve than seen in
the more classic position
Can use C-arm
 The minimum volume of injectate is dictated
by the volume of contrast required to
adequately cover the target structure, usually
between 1.5–2cc.
 pressure paresthesia
 paresthesia or dysesthesia into the lower
extremity.
 the needle is removed
 skin cleaned of any blood and antiseptic
preparation
 a sterile adhesive dressing applied.
 Bleeding
 Infection
 Mechanical nerve root damage can occur if
the needle inadvertently contacts the nerve.