Cervical Interlaminar Epidural
This is a minimally invasive, non- surgical, pain intervention done in patients suffering from chronic pain caused by irritation and inflammation of the spinal nerve roots in the neck (the cervical region of the spine) due to certain conditions or injuries. This type of chronic pain is called cervical radiculopathy, which can radiate down from the neck to the shoulders, arms and/or hands.
What is Cervical Epidural Space ?
The neck region of the spine is called the cervical spine. This region is made up of seven interlocking bones ( vertebrae ) that form the spinal column in the neck.
The spinal column surrounds & protects the spinal cord that extends from the brain to lower back.
The spinal cord is a very important bundle of nerves in the body that acts like a highway that connects the nerves located all over the body to the brain so that the brain can send signals and communicate with the rest of the body.
The epidural space surrounds the spinal cord like a sleeve and contains the nerve roots along with other connective tissue.
How does Cervical Interlaminar Epidural give pain relief to the patient?
Sometimes, nerve roots that are attached to the cervical region (neck region) of the spinal cord can become pinched or inflamed. This can happen, for example, if there is a herniated disc. The inflamed nerves can cause pain, and that pain may radiate down to the shoulder, arm and or the hands.
A cervical interlaminar epidural is a procedure where anti-inflammatory medicine is injected into the epidural space around the spinal nerves in the neck.
During this procedure Epidural space of the neck region is accessed through the interlaminar space between the adjacent vertebrae under fluoroscopy or X Ray guidance
The injected medicine coats the irritated nerves that are causing the pain and works to reduce swelling and pressure on the nerves. This allows the nerves time to heal and hence cause pain relief.
How is the Procedure Performed ?
The procedure is usually performed in the hospital, in a well-equipped Operation theatre. Patient has to sleep on his stomach ( prone position ), with a pillow under the chest, during the procedure. Patient is monitored throughout the procedure. Local Anaesthesia is given initially in the neck at the site of needle entry so that patient does not feel any pain during the procedure. Then the injection needle is guided towards the target under X Ray guidance. After confirming needle position, medicines are injected in the cervical epidural space. After observation post procedure patient is discharged.
Which Patients benefit from this preocedure?
Patients suffering from chronic pain in the neck radiating down to the shoulder, arms and/or hands which may also be accompanied by Tingling, numbness and or Muscle weakness caused due to Prolapsed Intervertebral disc disease in cervical region are most commonly benefited from this procedure.
Other conditions in which this procedure also might be indicated include –
- Cervical degenerative disc disease
- Cervical Spinal stenosis with radicular pain.
- Post spine surgery
- Post-herpetic neuralgia
What can be the complications of the procedure ?
Bleeding, Nerve Injury, Infection, Allergic reaction, inaccurate injection etc. are some of the complications of this procedure. That is why this procedure needs to be performed in a well – equipped operation theatre, under image guidance & by an experienced Pain Physician.
