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Thoracic Transforaminal Epidural Steroid Injection

What is a Thoracic Transforaminal Epidural Steroid Injection? 

A thoracic transforaminal epidural steroid injection is a minimally invasive procedure used to treat pain originating from an inflamed or irritated nerve root in the thoracic spine. By delivering a mixture of corticosteroid and local anesthetic medication directly into the epidural space through the intervertebral foramen (where the nerve exits the spinal column), this injection can help reduce inflammation and alleviate pain associated with conditions like herniated discs, spinal stenosis, or other sources of thoracic radiculopathy. 

How is a Thoracic Transforaminal Epidural Steroid Injection Performed? 

To perform a thoracic transforaminal epidural steroid injection: 

  1. 1. The patient lies down, and they may be given  medication to help them relax. 
  2. 2. The targeted area of the upper back is numbed with a local anesthetic injection. 
  3. 3. Using fluoroscopic (X-ray) imaging for guidance, the physician carefully inserts a needle through the numbed skin and soft tissues and into the epidural space, accessing it through the intervertebral foramen. 
  4. 4. A contrast dye may be injected to confirm the proper placement of the needle. 
  5. 5. Once the needle is properly positioned, a mixture of corticosteroid medication and local anesthetic is injected into the epidural space, bathing the affected nerve root. 
  6. 6. If the patient has multiple painful nerve roots, additional injections may be performed. 
  7. 7. After the procedure, the needle is removed, and a small bandage may be applied to the injection site. 

What Supplies and Medications are Used for a Thoracic Transforaminal Epidural Steroid Injection? 

The key components for this procedure include: 

  • – Local anesthetic (e.g. lidocaine or bupivacaine) to numb the injection site 
  • – Corticosteroid medication (e.g. triamcinolone, methylprednisolone) to reduce inflammation 
  • – Fluoroscopic imaging equipment to precisely guide needle placement 
  • – Contrast solution (optional) to confirm proper needle positioning 

The physician selects the appropriate medications and techniques based on the patient’s individual condition and needs. 

What to Expect After a Thoracic Transforaminal Epidural Steroid Injection? 

After the procedure, patients may experience some soreness or discomfort at the injection site, which can typically be managed with over-the-counter pain medication. 

The full pain-relieving effects of the steroid medication may take 3-5 days to be realized. In some cases, repeat injections may be necessary to achieve the desired therapeutic benefit, but many patients experience significant relief from just one or two injections. 

Patients should follow any activity restrictions and instructions provided by their healthcare team. They should promptly report any concerning symptoms, such as increased pain, numbness, or signs of infection, to their physician.

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