Epidural using fluoroscopy

[avglenn]

Can anyone inject( no pun intended) any info. on this. Was advised by Pm doctor that my back pain isn't derived from mechanical pain, but rather inflammation from a large amount of scar tissue from a prior Micro -d & from a disc thats torn all the way through , saying the acids from the nucleus polposus are inflamming the nerve. He said he wants to try a series of 3 ea. S1 transforaminal epidurals using Betamethasone. He said I could have pain for a few days after the injections but it should subside. Has anyone gone through these with any Luck ? Do they give you anything for pain prior to the procedure ? Oh ya, he did a leg/ knee/ ankle reflex test on me, everything responded fine, except the achillies ( back of my heals on both feet. He seemed stumped ? Dont know what thats all about. Thanks for any information !

[aestrella411]

I have had one epidural steroid injection with flouroscopy. Since it's with flouroscopy, that's good because then the doctor can be guided to exactly where he needs to put the injection. My question to you, well for your doctor, would be how does he know you are inflamed and THAT'S what's causing your pain?? Well the reason why I bring this up, is that unless they do other tests (ie discogram or something) they don't know for sure if it's inflamed until they actually perform the procedure that will rule that out. I had one ESI and they didn't do a second one (I don't know why your doctors are telling you they want to do multiple sets (of three I would imagine) when they don't even know if the first, second or even third one will work) because I didn't have 50% or more relief from the shot. Usually they will do a second or even third one and hopefully that provides relief. For me it didn't so now they are doing something called a medial branch block in which that will rule out facet joint pain. As far as my experience with the ESI, it was SO much better than what I thought it would be like. The only part that stings a little is the numbing shot they give you so they can afterwards stick you with the larger needle to get through the muscles to the epidural sac. That big needle doesn't hurt because it's so deep into your tissue, it just doesn't hurt. You only feel pressure. The only part that hurt during the procedure was the numbing shot. (Have you ever gotten a filling with novicane?? Well it's the same thing). The steroid shot itself doesn't hurt tho. I must admit though, after getting home from this procedure, that's when I had some fairly bad muscle pain. I was more restricted than usual in my back mobility but that's because the big needle had to through the muscles. It's just muscle soreness, the pain that you will get. Other than that, the procedure wasn't as bad as I thought, not even close. I thought I was going to need to be knocked out I was so scared. But now, I know I could do that again if they wanted me to and I wouldn't be worried a bit about it. I hope if this doesn't work for you that they DON'T keep giving you more shots. That would be bad. Steroids aren't (to say the least) good for you. It inhibits your body's natural ability to fight infections and that's why if you do have some sort of infectious cold or anything, they won't do the shot. If you DO need something during the procedure for the pain (or just being too worried to go through with it) they can give you something to calm you down. The only downfall about that is that it'll make your hospital stay much longer. You only stay in there for maybe an hour to an hour and a half then they release you. As far as the achilles reflex not working to well, I'd get that checked out because that is nerve damage. Good luck! -Anita

[avglenn]

Thanks for the good info. Anita. The doctor based his findings of inflammation off an Mri I had done recently, post-op. I had the Mri done w/ contrast. The doc was showing me where it revealed the infammation around the S1 nerve from L5-s1 surgery and how badly dessicated the L4-5 disc was. he said more than likely the acids leaking out from the torn disc could be the culprit of inflammation too. He said the shots are usually done in series of 3. Based on ,if the first one helps or not. Thanks again !

[injured betty]

I had a ESI last week. I forget which day. He gave me Demerol and Vesad, first, in the arm, to relax and kill the pain. I understand that is not normal procedure.

He gave me three ESI's in the same area. Again, not normal procedure. He said that the local would work for a few days and then the steorid should kick in. I am still waiting for the steroid to kick in, it hasn't. I am suppossed to have another one, this time with a flourescope. I am going to pass. The first and second ones didn't work so I am not going for another one.

My butt, where he put it, is so sore that I can hardly walk or sit. I am just hoping that that pain from the shots goes away soon.

I looked into the nerve ablation but was told that it was experimental. If I thought that it would work, I might try it.

danagc: Even with contrast, how were they able to determine where it was inflammed? What did it look like???? I didn't think that they could see inflammation with an MRI.

[avglenn]

As far as my Mri, I've never had a doctor explain the actual pictures of the disc, thecal sac, etc.. before this PM dr. The best I recall, so dont quote me, cause this guy went over this fast and to try to distinguish the details were tough to me. The scar tissue sorrounding the nerve was all blackened, but had a small white spot in it, which he said was signs of inflammation. I was quizzing him on my L4-5 disc, because its not in very good shape & indicates a grade 4 tear, ddd. I asked him if that could be the pain generator with my back. He said yes it can be and if its torn all the way through the acids will leak out and cause all sorts of problems, inflammation being one of them. This may not clear up your question, but when I talk to him again , I will get a more detailed explanation and write it down. I have a number of issues going on, and my brains like teflon, nothing sticks. Thats a very good question and I will keep you updated. Thx for the input !

I saw this in an article I was reading..




Magnetic Resonance Imaging (MRI) of the Spine

Test Overview

Magnetic resonance imaging (MRI) is a test that uses a magnetic field and pulses of radio wave energy to provide pictures of organs and structures

In some cases a contrast material may be used during the MRI scan to enhance the images of certain structures. The contrast material may help evaluate blood flow, detect some types of tumors, and locate areas of inflammation.