Lumbar interlaminar epidural steroid injection side effects

During the ILIF procedure, the surgeon makes a small incision in the lower back and an opening is created through the ligaments. This allows access to the spinous processes (the bone you can feel when you run your hand down your spine). The damaged portion of the disc is removed and allograft bone is placed in the empty space. This helps protect the spinal cord and nerves. A metal implant is inserted to stabilize the spine and secure the spinous processes until the fusion takes place. Morsellated bone is used together with the allograft to fuse the vertebra above and below.

If you are using an old operating system, you may find that Google Chrome will allow you to visit modern websites without requiring an update to your operating system. Learn how to update your browser The ILIF Procedure (Interlaminar Lumbar Instrumented Fusion) was developed to overcome the potential shortcomings of standard lumbar spinal stenosis treatments (. decompression alone and decompression with fusion), using a minimally disruptive surgical technique. Lumbar spinal stenosis is a gradual narrowing of the space where nerves pass through the spine, which can be a result of aging and “wear and tear” on the spine from everyday activities and/or resultant positional changes of the vertebrae. The most common surgical treatment for lumbar spinal stenosis is a procedure called a decompression, which involves removing bone or ligaments that are pressing on the spinal cord and/or nerves.
The ILIF procedure involves a minimally disruptive decompression procedure called a laminotomy, which involves temporary distraction (opening up) of the space between the spinous processes, and careful removal of only small sections of bone to release the pressure on the spinal cord and nerves.

I am a patient of Dr. Jeffrey Oppenheimer, who is my spine doctor. I have gotten wonderful care from him and all the PAs and staff. At Hollywood and Palm Beach Gardens. They are extremely talented and I could not ask for a better knowledgable doctor in his field. He is kind, patient, and takes the time needed to answer your questions and concerns. He has helped me so much. I will have the lumbar operation with him as my doctor. Also, I was referred to Dr. Shapiro in that group who is a knee doctor. I have gotten an MRI now and he prescribed a physical Therapist that is really helping me. This is the third set, the other two were Prescribed by another doctor that I did not get the hands on treatment from. I can not say enough good things about this group of doctors, PAs and their group.

Contrast is used to verify epidural location and to indicate the distribution of injectate. Some physicians use contrast as a volume expander while others prefer saline for this use. The contrast is typically nonionic and lowosmolar. In patients with contrast allergies gadolinium can be safely used in most lumbar procedures. 30,31,52,53 If using gadolinium, the amount should be just enough to document epidural injection. Gadolinium should not be used as a substitute for volume expander. The typical amount of contrast or contrastsaline mixture used for either cervical or lumbar interlaminar epidurography is 4 cc to 5 cc (less in nerve blocks; see below). A smaller amount will not provide sufficient contrast for an epidurogram to evaluate for adhesions or distribution of injectate. For coding purposes, an epidurogram is considered to have been performed when approximately 4 cc to 5 cc of contrast is injected regardless of the route (transforaminal or interlaminar). The report, CPT code, and amount billed must be adjusted if an epidurogram is not performed. The amount of contrast injected may be reduced in spinal stenosis. Many patients will feel pressure or leg cramping from almost any volume, no matter how small. Patients undergoing first-time injections may confuse this with pain. Careful questioning and reassurance that pressure is normal will be adequate in most cases. The injectate volume should be reduced if significant pain is experienced.

Lumbar interlaminar epidural steroid injection side effects

lumbar interlaminar epidural steroid injection side effects

Contrast is used to verify epidural location and to indicate the distribution of injectate. Some physicians use contrast as a volume expander while others prefer saline for this use. The contrast is typically nonionic and lowosmolar. In patients with contrast allergies gadolinium can be safely used in most lumbar procedures. 30,31,52,53 If using gadolinium, the amount should be just enough to document epidural injection. Gadolinium should not be used as a substitute for volume expander. The typical amount of contrast or contrastsaline mixture used for either cervical or lumbar interlaminar epidurography is 4 cc to 5 cc (less in nerve blocks; see below). A smaller amount will not provide sufficient contrast for an epidurogram to evaluate for adhesions or distribution of injectate. For coding purposes, an epidurogram is considered to have been performed when approximately 4 cc to 5 cc of contrast is injected regardless of the route (transforaminal or interlaminar). The report, CPT code, and amount billed must be adjusted if an epidurogram is not performed. The amount of contrast injected may be reduced in spinal stenosis. Many patients will feel pressure or leg cramping from almost any volume, no matter how small. Patients undergoing first-time injections may confuse this with pain. Careful questioning and reassurance that pressure is normal will be adequate in most cases. The injectate volume should be reduced if significant pain is experienced.

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