The Vault

Lumbar Transforaminal Epidural Steroid Injections. (TESI)

Lumbar TESI injections are a unique injection that places epidural steroid in the neural foramen, the area of the spine where the nerve root exits. This is the most common area of nerve impingement, often from a disc or enlarged facet. By placing the medication right at the site of irritation we maximize your chances of success. This is an advanced technique performed by experienced interventionalists.

An IV is started and sedation is given. You will not be under general anesthesia. Pathology in the spine can cause distortions that push the nerve into areas that it normally does not reside. As we approach the foramen, we will cautiously advance the needle and ask for any signs of bumping the nerve. You may feel a mild parasthesia into your leg, which will allow us to adjust the needle accordingly. Practitioners putting patients under general anesthesia place you at risk of injecting into the nerve, which could have long lasting consequences. Once the area of interest is obtained, dye is injected under live X ray to confirm proper needle placement. Anti-inflammatory steroid is then injected and the procedure is complete.

Patients should see a positive effect in the first three days after the procedure as the medication takes effect. Often a series of injections is needed to undo the cycle of compression, pain, and inflammation of the nerve.

Epidural steroid injections have provided lasting relief to many of our patients and helped them avoid surgery.