Information on Cervical Transforaminal Epidural Injection (CESI) from Dr. Rathi

Dr. Rathi will be performing an injection procedure on your spine. The purpose of the procedure is to help relieve pain believed to be originating from one or more spinal nerves as they exit from the spinal canal. These joints may become “inflamed” or swollen after a sprain or tear of nearby structures including the intervertebral disc.

You will by lying face down on a procedure table. An x-ray machine or “fluoroscope” will take pictures of your back.

A mild sedative may be given if needed.

A very thin needle will be inserted through the skin and into muscle. Local anesthetic will be used as necessary. The needle will be guided using the x-ray images to the exiting spinal nerve and nearby intervertebral disc. “Contrast” is a liquid that appears dark on x-rays and when injected, verifies proper positioning. Images including an epidurogram will be taken. A mixture of anesthetic and steroid will be injected. The purpose of both medications is to see the immediate and late effects.

COMPLICATIONS ARE RARE

Complications from needle entry:

  1. Soreness in the muscle from the needle. This is usually mild and resolves in 1-2 days.
  2. Bleeding
  3. Infection
  4. Injury to a nerve
  5. Headache
  6. Quadriplegia
  7. Death

Complications from medication:

  1. Allergy: Rare allergies to Versed, Lidocaine, Marcaine, and Steroids have been reported. Like any allergy, it can potentially cause respiratory distress and would require hospitalization. Emergency equipment is always available during procedures.
  2. Side effects of steroids: Also rare. May cause facial flushing, anxiety, irritability which resolves in a few days. It does not cause weight gain or osteoporosis in small doses as is used in spine injections. If you are diabetic, you may find an increase in your blood glucose for 1-2 weeks. If you are female, you may find a change in your menstruation it may come earlier than usual.

If your neck feels better, you should take it easy, be careful and do not “over-do it”.

On the way home, lie in the back seat or in a position most comfortable for you.

You should be able to resume normal activities by the next day.