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Lumbar Steroid Injection

Kyphosis refers to the forward curvature of the spine. Kyphosis is actually a normal term. The transition to kyphosis is being transformed from the humpbacked and accompanying kyphos.


Epidural steroid injections (ESIs) are a common treatment option for many low back and leg pain conditions. They have been used for decades. They are considered an integral part of the non-surgical management of sciatica and low back pain.

The injection is called an epidural steroid injection because it involves injecting local anesthetic and steroid medication directly into the epidural space surrounding the spinal cord and nerve roots.

It can be safely applied in the presence of scopy in low back and lower back leg pain due to herniated disc, canal narrowing, calcifications in the waist.

Purposes of Epidural Steroid Injection:

  • Control pain by reducing inflammation in and around the nerve roots
  • Improves mobility and function in the lower back and legs
  • Allows the patient to participate and progress in a comprehensive physical therapy and rehabilitation program
  • An epidural steroid injection may be recommended after a number of nonsurgical treatments such as medications and physical therapy have been tried and before surgery is considered.

Epidural Injection Approaches

This type of injection can provide acute and significant pain relief, as it delivers a steroid medication with potent anti-inflammatory effects directly to the painful area near the spinal nerve(s). An epidural injection can be done using any of the following approaches:

Transforaminal route: This technique provides a gentle delivery of steroid solution into the epidural space near the area where the nerve is likely to be irritated. This injection technique targets specific nerve roots to control inflammation and pain.

Interlaminar route: In this technique, the needle is inserted from the back of the spine and the drug is released into the epidural space. This method is less precise because it does not release the drug near the target nerve root and the steroid solution is free to diffuse within the epidural space.

Caudal route: This is a general approach, easy to apply, but the drug does not go directly to the source of the pain in the epidural space and around the nerves. The caudal approach may be less effective, but is considered safer and easier to implement. This method can help control widespread or widespread pain.

Effectiveness of Lumbar Steroid Injection

Current research shows positive results from these injections in 70% to 90% of patients with pain relief from one week to one year. If a good initial response is seen, a second injection may be considered when there is improvement. It starts to decrease from the first injection. Typically, up to 3 injections can be given in a 12-month period.

Technique of Lumbar Steroid Injection


The injection is usually given with the patient lying in the prone position on a fluoroscopy (live x-ray) table. The process can take up to 10-20 minutes.

To administer the injection, it is decided to use a transforaminal, interlaminar or caudal route according to the patient's complaints and the pathology that explains this situation.

The needle is placed on the target point simultaneously with the imaging device we call the scope.

Then, the place of spread of the drug is tested by giving a contrast agent.

Then the procedure is terminated by giving a mixture of steroid and local anesthetic.

A tingling or mild burning sensation or pressure sensation may be experienced as the medication enters the epidural space. Once the injection is complete, the irritation and discomfort will usually go away within a few minutes.

The patient is usually followed for 30 minutes to an hour in a recovery room and sent home. The success rate is between 80-90% in appropriately selected patients, and the effect is between 3 months and 1 year.

The brace is commonly used for kyphosis, especially in skeletally immature patients. The goal is to prevent further progress during times of rapid growth.

The corset is not an effective treatment for adult patients. The corset is similar to that used in scoliosis patients. However, as each spine is different, the location or type of brace may differ, and therefore each brace should be tailored to the patient.

Thoracolumbar (TLSO) brace or Boston brace is generally recommended for those who need a brace. It fits and molds specifically to the patient's body. This type of corset can be worn under clothing and patients can still participate in sports and other activities.

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Surgery is an option for those with symptomatic or severe kyphosis that does not improve with non-surgical methods. Corrective surgery is usually recommended when curves are greater than 80 to 90 degrees measured on X-ray.

Sometimes kyphosis can extend to the middle or lower back, and in these cases, earlier surgery may be recommended for those with 60-70 degrees kyphosis. Surgery may also be an option for those with severe or disabling back pain, or when kyphosis causes compression of the spinal cord or nerves.

It requires a good planning in surgery, surgical techniques vary according to the pathology of the patient, and an operation called screw stabilization is required.

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