Spinal epidural injections to treat back and neck pain are a common nonoperative procedure. An epidural allows the physician to administer a more potent dose of corticosteroid medication by needle precisely to where it is needed. Longer acting corticosteroid preparations such as Depo-Medro are safely used to treat low back pain. Celestone® is a more soluble, less particulate corticosteroid medication used in cervical epidural injections.
In my practice, I perform lumbar (lumbosacral) and cervical epidural corticosteroid injections in a sterile procedure room using fluoroscopic guidance. Fluoroscopy is a low dose x-ray that allows the needle to be safely and precisely guided. The patient is given MAC anesthesia (Monitored Anesthesia Care; monitored sedation) by an anesthesiologist or registered nurse anesthetist. Patients are more comfortable during the procedure and they appreciate the added level of TLC. Medicare and most insurance carriers provide reimbursement for the procedure as described.
Another advantage to administering corticosteroids directly by epidural injection is there are fewer side effects than with prolonged oral administration of these drugs