Right l5 transforaminal epidural steroid injection

Patients with worker's compensation claims have less relief from symptoms and less improvement in quality of life following surgical treatment of lumbar disc herniations. Despite this, they have near equivalent return to work status at 4 years.

Atlas et al. (2006) showed at 5-10 years, most patients, regardless of baseline workers' compensation status, were employed (78% for both groups). However, workers' compensation patients had worse symptoms, functional status, and satisfaction outcomes.

Atlas et al. (2000) found patients who had been receiving Workers' Compensation at baseline had significantly less relief from symptoms and less improvement in quality of life, however, they were only slightly less likely to be working at the time of the four-year follow-up.

A local anesthetic will then be injected into your skin to make it numb. The specially designed needle will then be inserted through the numbed skin and slowly advanced into the specific foramen using fluoroscopy (live X-rays) to guide the needle. Once the needle is in the proper location, a small amount of contrast will be injected under live X-ray to ensure that the medication will spread properly. After this, the corticosteroid will be slowly injected into the epidural space. Once the injection is complete, the needle will be withdrawn and a dressing will be placed over the injection site.

  • The exiting mixed spinal nerve gives off the eventual medial branch that supplies the facet joint at that level, and the joint immediately below .
  • Therefore, each zygapophyseal joint receives innervation from the medial branch at that level, and from the the medial branch above it.
  • Photo (right): Note the facet joints (with capsule) have nerves (yellow) from the same level, and from the level above.
  • Example: The L4/L5 foramen has the L4 mixed nerve exiting.  The L4 dorsal ramus gives rise to the medial branch, which then innervates the L4/L5 facet joint (same level), and thebelow L5/S1 facet.  That same L5/S1 facet also receives innervation from the L5 dorsal ramus.
  • Note: The L5 dorsal ramus does NOT have a medial branch, so you block or “burn” the dorsal ramus itself.

    Right l5 transforaminal epidural steroid injection

    right l5 transforaminal epidural steroid injection

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