Why are you having this procedure?

The epidural space surrounds the outer covering of the spinal cord (dura) and extends from the skull to the tailbone.  It contains fat, blood vessels and nerves that  pass through the space after they leave the spinal cord.  

Epidural injections are used to provide anaesthesia during surgery, analgesia following surgery or are used for the diagnosis and/or treatment  of pain due to inflammation of the structures in the spinal space.

How do I prepare for this procedure?

Please advise Absolute Radiology Staff if you are;

• Taking blood thinners  (at least 5 days prior to your procedure, especially warfarin, clopidogrel, ticagrelor, aspirin or anti-inflammatories).

• Pregnant (or possibility of pregnancy)

• Allergic to betadine, iodine, shellfish, local anaesthetics, or plasters.

• Unwell (especially if you have an infection, cough or cold) as this may mean your procedure needs to be deferred until you are well.

Any other specific individual instructions will be given to you in advance.

Consider if you need to have someone to accompany you home, or drive you home.

What does this procedure involve?

You will require a referral from an Orthopaedic Consultant prior to have this procedure.

You can bring this directly Absolute Radiology, have this faxed or email this to us.

We will then contact you and liaise with an appointment date and time that suits you for this procedure, time taken for this procedure is usually between 10 –20 minutes.

When you arrive on the day we will ask you to complete a patient questionnaire and check all your details.

Following this you will be escorted to a changing room  and requested to change in to a patient gown.

Our Radiologist will see you prior to the procedure, answer any questions that you may have and ask you to complete a consent form for your specific procedure.

Once this is done you can move to the CT scanning room where the procedure is completed.

We ask that you position yourself on your tummy for this procedure. 

We place a sticky marker on your back that assists in isolating the area of interest and do some initial scanning to locate the specific area for treatment. 

We use a marker to note this position on your back.

The skin will then be cleaned with antiseptic solution, a clean drape is placed over your back and local anaesthetic injected in to your skin to numb this region.

A special spinal needle is then inserted in to the skin.

While the needle is placed we move you in and out of the scanner and staff move in and out of the room until the precise placement is achieved.

At this point the steroid is injected, needle is withdrawn and a plaster applied to the area.

Post procedure

Once the procedure is completed we move you back to the changing area and ask for you to remain for approximately 30-60 minutes for monitoring.

You may experience some numbness and/or relief of your symptoms for several hours following the procedure, and sometimes some light-headedness on standing.  These symptoms will resolve over the next few hours.

It is preferable that you have someone to drive you home and/or stay with you for next 24 hours.

You can remove the plaster the following day when you shower or wash.

Some people find their pain or discomfort returns when the local anaesthetic wears off, and occasionally an initial pain increase with stiffness for a few weeks prior to pain resolving.  If required an ice pack can be applied to this area of discomfort for the first 1-2 days following the  procedure.

If steroids have been injected if may take several days for the benefits to be noticed.  You may feel flushed in the face and/or notice a change in mood for a few days

Mobility and exercise following this procedure should not be a rapid increase in activities. You can gradually increase your daily activities as tolerated.  Discuss this further with your referring Doctor.

If you notice any swelling , bleeding, redness, experience any fever, inability to pass urine, severe headache, increased weakness and/or numbness or have any other concerns please see your GP in the first instance, or alternatively a after hours practice or attend the Emergency Department.

Risks of the procedure

All procedures carry risk of complications. In general the risk is low, but includes;

• Discomfort at the site of the injection

• Worsening pain (probably a temporary ‘pressure effect” from the injected volume of medication.

   Infection

•  Bleeding

•  Allergic reaction to the medications injected

•  Fainting

•  Headache

•  Difficulty passing urine (may persist for 12-24 hours after injection)

• Nerve damage (due to trauma, medication, infection or bleeding).

• Steroid related side effects such as flushing, mood swings, high blood sugar readings. Steroid manufacturers did not specifically design them for this use, but they have been widely used for many years without significant complications.

•  In rare instances bleeding in to the epidural space can cause compression of the spinal cord, leading to paralysis and the level of the injection.  Damage to the spinal cord and spinal nerves by the epidural needle may very occasionally occur.

Sedation Info

If you require sedation for this procedure you will need to discuss this in advance with your GP. If this is required they can provide you with a prescription for a sedative to collect from your chemist. You will need to bring this prescription with you to your appointment and to have advised us in advance that you require sedation as additional monitoring of will be required prior to your procedure and after your procedure.

You will also require someone to drive you home, and stay with you for the next 24 hours

Side effects of some sedation medications can last for up to 24 hours following administration.

You may not remember some of the information discussed, this is a normal side effect.

For the next 24 hours you should not;

• Drive or operate any vehicles or machinery

• Drink alcohol

• Make any important decisions,

• Sign any legal documents

• Travel unaccompanied

If you have any questions prior to your appointment, please call us to speak to our nurse.