EN
Spinal Injections are used for both treatment and pain control in patients with acute or chronic low back, upper back and neck pain. Success rates have been reported between 60% and 90%. Injections should be guided by special imaging devices such as ultrasound or scopi.
Spine injections applied in our clinic:
What is Epidural Injection? How is it done?
Epidural injections are administered in three different ways. There are three different applications, made from the middle part of the vertebrae, made from the part close to the tail, and finally made into the nerve channel. Caudal blockade, which is made from the side close to the tail, can be performed in the presence of ultrasonography. The success rate of this treatment is 70% at the bottom of the waist with a long spinal needle under ultrasound guidance. Epidural injection made from the middle of the belly is a technique that has been applied for a long time and it is preferred especially in the midline hernia with broad base narrowing and narrowing of both nerve canals.
Transforaminal Epidural Injection (Direct Nerve Canal Injection)
Most of herniated hernias come from one side. Therefore, the method of nerve canal injection has been developed, starting from the idea of making a nerve canal for the treatment. For example, a patient with a right L4-5 hernia can be treated directly by making a point shot to the right L4-5 'nerve canal. The advantages of this method are; Since only one nerve channel is made, only the desired site is treated. Side effects are less common because the drug used is lower than the dose. Since injected directly into the affected nerve and hernia region, treatment benefit and success rate are higher.
Transforaminal injection can not be blinded. It is made in the presence of a special x-ray device called a C-arm scoping. With this device, the needle is correctly placed in the nerve canal by displaying 3 different platelets of the lumbar vertebrae. The process takes about 10 minutes on average. A slight anesthetic will prevent the patient from feeling pain during the procedure. After the procedure the patient should be observed for about 1 hour. He may go to the patient's home later. There may be temporary numbness and weakness in the patient's leg after injection, so driving is not recommended.
What are the therapeutic agents used in epidural injections?
The most common drugs used in epidural injections are cortisone and local anesthetic drugs. These drugs are effective in eliminating edema, inflammation and adhesions in the nerve and hernia components. Cortisone is a safe and effective drug when it is used in appropriate doses and numbers. Drug intake is the lowest in the nerve channel injection method and the success rate of treatment is the highest. Besides epidural therapy, radiofrequency flow therapy is also used in epidural therapy. In particular, it is preferred in patients who do not benefit from conventional treatments, who have undergone surgery several times, and who suffer from the use of cortisone and anesthetic drugs.
In which situations is epidural injections applied? Repeatable?
It is applied in waist and neck hernias which cause nodal edema and inflammation, after failed lap surgery, in spinal canal narrowing, facet joint disorders. Pain is completely lost in the majority of patients undergoing epidural injection. Symptoms such as numbness, numbness, muscle weakness associated with pain also show significant improvement. The procedure can be repeated for a small number of patients who are not able to recover. General acceptance means that the process can be applied 3 times in a few months. Loss of the pain does not mean that it is fully recovered. Therefore, short-term rest after the procedure and rehabilitation program should be started after that.
What are the Risk and Side Effects of Epidural Injections?
Epidural injections are treatments that have been done safely around the world for about 50 years. Side effects are very low in injections made with imaging assistance. The entrance of the needle into the nerve channel and the contrast agent in the nerve channel can be seen live from the screen and an extremely safe injection can be made. Nevertheless, despite all the technological developments and precautions, there may be some undesirable effects due to the process itself or the drugs used. The most common side effects are; temporary headache, temporary pain due to injection, and drop in blood pressure during injection. Much more rarely is the risk of bleeding and infection.
