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Many of our patients suffer from pain that relates to disorders in the spinal area, such as disc herniations, previous back surgeries, or complex regional pain syndromes that require nerve blockade in and around the spine.
Since the spinal cord is surrounded by spinal fluid contained in a membrane called the dura, injections done inside the spinal sac are called "sub-dural", or "spinal injections." If the injection is done in the space just outside the spinal sac (dura), the injection is called "epi-dural", meaning "above the dura." Through the epidural space, injected medicine can reach the spinal sac, the spinal nerves, and can extend both up and down the spine beyond the level of injection. Injection into the epidural space eliminates the need to make a puncture in the dura. This is important to avoid spinal headache.
Epidural injections treat the inflammation, chemical irritation, and other pathology associated with disc rupture and disc bulge causing back and neck pain at the spinal nerve level. Clinical experience shows that many patients have dramatic responses. A recent study demonstrated pain relief for more than 2 years in 78% of 200 consecutive patients.
A retrospective study combining comprehensive rehab with epidural steroid injections yielded a 90% good to excellent outcome with a 92% return to work rate. For patients in both studies, the alternative would have been a major surgical procedure.
Relative to surgery, epidural injections are safe and inexpensive. They are done on an outpatient basis with little or no down time and do not have the morbidity or mortality rates associated with surgery and general anesthesia.
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