What happens during a Cervical Epidural?
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- Опубліковано 13 чер 2024
- This video will explain what a cervical epidural is, how it is performed in a surgery center, along with discussing potential risks and outcomes of the procedure.
Cervical Epidurals are a very common treatment for patients suffering from numbness, weakness, pain, or tingling caused from a pinched nerve. Introducing steroids into the epidural space around the effected nerves can help reduce inflammation and help reduce the patient's discomfort.
#thespineguy #cervicalepidural #selectivenerverootinjection #fluoroscopy #postduralpunctureheadache #interlaminar #steroid #steroidinjection
Dr. Brian W. Su, MD
Spine Surgeon
Chief Development and Strategy Officer | California Orthopedics and Spine
Medical Director of Spine Surgery | Marin General Hospital
Director | Marin Healthcare District Board
Chairman | Marin Specialty Surgery Center
Timestamps
0:00 - Intro
0:18 - What is a Cervical Epidural Steroid Injection?
0:42 - What does a Cervical Epidural Steroid Injection do?
0:34 - Who performs a Cervical Epidural Steroid Injection?
1:12 - Explanation of what a Cervical Epidural Steroid Injection is.
1:34 - Types of Cervical Epidural Steroid Injections
2:03 - Types of medications used in a Cervical Epidural Steroid Injection
2:25 - Where are Cervical Epidural Steroid Injections performed? Office or Surgery Center
3:03 - Patient's position during a Cervical Epidural Steroid Injection
3:54 - Description of a pre-procedure "Time-Out"
4:11 - "Time-Out" being performed
4:33 - Dr. Naidu describes a Cervical Epidural Steroid Injection
4:55 - What happens inside the procedure room
6:29 - Needle being positioned
8:17 - Procedure ends
8:40 - Recovery area after a Cervical Epidural Steroid Injection
8:58 - Top 2 risks of a Cervical Epidural Steroid Injection
10:03 - What do if you get a postdural puncture headache?
10:30 - Actual risks of a Cervical Epidural Steroid Injection in real life percentages
11:22 - After the Cervical Epidural Steroid Injection
11:37 - Recovery after a Cervical Epidural Steroid Injection
11:50 - Expectant results of a Cervical Epidural Steroid Injection
12:01 - How often can you get a Cervical Epidural Steroid Injection?
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Disclaimer: This video is not intended to provide diagnosis, treatment or medical advice. Information obtained from this video should not be taken in lieu of your own medical provider's advice and treatment plan. Please consult directly with a physician or other healthcare professional regarding any diagnosis or treatment plan options. Content provided on this UA-cam channel is for informational purposes only and should not be considered as a substitute for advice from a healthcare professional. The statements made about specific products throughout this video are not to diagnose , treat, cure or prevent disease.
Just had my second injection today. First one lasted about 5 or 6 months. Helped with the pain but more importantly it stopped the vertigo I was having.
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Thank you for showing start to finish.... I'm so glad you showed the entire procedure like the good old days of youtube.
Nothing is sugar coated or blurred out.. now I totally know what to expect for my injection coming up.
It has lowered my anxiety about it tremendously. Beautiful facility!
Thanks again! 🙂🙂👍👍
Hearing those risks now makes me wonder if I should do it! :(
This was an incredibly educational video. Patients should take responsibility of their health care and first they need the knowledge, you are graciously providing that information. Thank you very much!
Very, very informative. You're the best and provide the most info and details on youtube. Thanks
Thank goodness you are here to help!
Excellent explanation as always. Thank you Dr. Su.
Appreciate this perspective from the providers, since I have gone through it but obviously did not have the view of what was going on. Thank you!!
Excellent video and description! Thanks
Thanks for such a detailed video Dr.
Had my first injection today Superior Spine and Joint in Dallas, TX they were awesome and very helpful
Very informative thank you for your expertise in explaining the process of a cervical epidural.
You were so detailed very helpful.
You are wonderful for providing this information Dr Su . I wish I was able to be treated by you unfortunately I’m in Australia
Thanks for these videos
Very helpful. Thank you for sharing!
Beautiful explanation
I am a IR / Cath Lab Tech who has to get this done. Thank you so much for this awesome content
Thank you for this information. I will be getting this instead of surgery for now. I have two bulging disc and the pain is always there.
thank you
Dr. Su
Thank you once 3 years pain free. MM
May I ask what is MM?
**HIGHLY SUGGEST WATCHING TO THE END** Thank you for providing such a detailed explanation of what this is and how it is done start to finish with things to help during recovery. Fantastic job
I’m having this done through Stanford University for a pinched nerve in my neck. I don’t think it’s gonna do much because I have every symptom for complex regional pain syndrome and I’ve had it since for about six months now with no resolve I think my fingers are going to stay twisted now because they don’t seem to really care at least this doctor doesn’t. I’m still trying to raise my kids. It’s so messed up can’t drive hardly at all too much chemotherapy I guess. Grateful to be alive but I’m definitely not living.
Thank you.
Good explanation.
I have had this without sedation and it was no big deal.
Thanks
Great video. Just had my first C7/T1 injection, thoracic interlaminar under twilight sedation today. Great experience and looking forward to know more neck pain!!!!
I have mine next week for the same C7/T1 area.....
❤ I really like your videos. I have hernias. L4,L5L,L5, S1. And C6-C5. C5-C4
Thank you.🙏😘
Thank you! You are so good at explaining procedures. All the experience along with his knowledge if phenomenal! He explains procedures and or spinal information in layman's terms while also explaining the technical vocabulary. He is fantastic!! I would really like to be near where he practices to become one of his patients. I have syringomyelia in my thoracic area,with kyphosis. Spinal disk herniated in cervical, thoracic,lumbar areas some into the thecal. Both neurosurgeons I have went to said the same thing. Even if they could repair my spine, I would have hardware from top to bottom. The syrinx in my thoracic area would probably rupture. I would love to know what happens when that syrinx decides to rupture????? Please. They say the odds are about 70% failure with or without surgery. Thank you
I also have scoliosis
Cool video!
Very detailed video thank you. Just had this injection today
Did you get better?
I'm here because I received my first shot today and didn't get all this information from my MD 😮
How you feeling after
I get my injection on 3/29 I’m so nervous but I’m just ready to not be in pain anymore!
I had this done years ago on my neck and it worked beautifully. I have another coming up for my lower lumbar spine but now I have many reservations. One was tried but doctor couldn't put the needle in, much pain, no numbing, total failure. Now I can only walk half a block.
Thank you Dr Su. Can you show a video about sciatica with low back pain, hip, leg and foot pain? I've had this pain for several months now and it seems to he getting worse and goes bilateral at times but mainly in right leg. Thank you for these wonderful videos.
Please watch the episodes on lumbar spinal stenosis
Hello Suzanne
Dr do you have a video on laser ablastion?
I swear I have the same thing. Got epidural on Thurs but back in pain Sat. Ugh!
Hi Doctor, I have schedule to have pain management shot next week. I am so nervous about different video from different doctors. Does it safe?
I hope there’s a medicine study for me. I have no hope in any of my hernias I just take tramadol for pain
Best spine channel on UA-cam!!! Imo
That was very interesting and informative doctor.. i just shared it with others I know.. I also just had this done on lumbar last week to help keep me walking with less pain..
I have a question please.. What’s your thoughts on the Superion implants for sever spine stenosis? Have you seen good results from this procedure? This is an outpatient procedure performed by the pain management specialist.. Will it work if a lumbar laminectomy is needed in the same area? Thank you for your time and expertise it’s greatly appreciated Dr. Su ..
That implant is not indicated for severe stenosis
@@DrBrianSuTheSpineGuy ok thank you .. I was under the impression it’s specifically for stenosis or helping to stop the stenosis.... I greatly appreciate your time Dr. Su .. I wish I could have you for a doctor..
Excellent in explaining the procedure. I am having this done tomorrow morning, and it helped me to understand what will be taking place. I am still a little anxious, but a little less frightened. Thank you, Dr Su, for explaining this procedure in lamens terms.
What I would like to know, Dr. Su, is physical therapy recommended after the procedure? If so, how long should I wait before restarting it. Thank you!
Hi Dr Su you have done it again with such a great video explaining this procedure in a very simple way 👍👏
This Monday I had CT Guided C6 (left side) Nerve Root Injection at the Alfred Hospital here in Melbourne Australia. I believe that it was a transforaminal steroid injection as you explained because I was lying down on my back with my head turned to the right around 45 degrees I believe. They inserted the needle at the left side, base of my neck where they first injected some local anesthetic, then they performed the procedure. I was awake throughout the procedure. The problem is that after I left the hospital and the local anesthetic wore off, my C6 pain had increased dramatically, more than before the procedure. The pain has been excruciating when lying down, sitting down, when trying to sleep which was impossible. I was under the impression that I would be getting relief after this cortisone injection, but after 4 days I still feel very sharp pain starting from C6, going down the neck (it feels like a very intense sharp stabbing relentless pain), part of the thoracic spine, into left shoulder, arm, index finger, the groin and left foot when sitting or lying down. What could be causing this new added pain? Is this normal? Will the extra pain disappear and reduce eventually? I am a bit worried because the pain is stressing me out. Will the cortisone eventually work? Thanks.
It can take up to 2 weeks to work.
@@DrBrianSuTheSpineGuy Hi Dr. Su thanks for your reassurance. I forgot to mention in my post that, before the CT injection, I have been suffering and still suffer from intermittent left sided head/facial numbness/slight dizziness and intense short (2-5 minutes) sharp headaches on the top right of my left eye and forehead. Could this be caused by the cervical nerves? Thanks again
@@DrBrianSuTheSpineGuy so more pain is to be expected after the procedure???
Thank you Dr. Su for the video. I’m going to get my Bilateral TFESI L5 SI next Wednesday.
@@DrBrianSuTheSpineGuy
Please doctor can I ask if this injection could work for me and in which C number do think I have to get injected.
I really appreciate your answer as I am in sever neck pain..here is my MRI RESULT
MRI CERVICAL SPINE
History: OA. Left radicular pain.
Results: The previous MB of 2021 has been reviewed. There is disc narrowing with loss of T2 signal at C4/5 and C5/6.
There is slight loss of height of cervical and thoracic vertebrae, unchanged since 2021. The spinal canal above C4 and below C6 is capacious. The upper cervical cord and medulla appear intact. The facet joints are normally aligned.
No compressive disc protrusion is seen from C2 to C4. The neural foramina are patent. At C4-5, the disc is mildly protruding. C5 nerve root impingement is not suspected.
At C5-6, the disc is protrading. There is no cord compression. Acquired foraminal stenosis is present bilaterally particularly on the right with decophyte formation, with evidence of C6 nerve root impingement. The C6-7 and C7-T1 discs are kormal. The C7 and C8 nerve roots are clear.
Comment: There is acquired foraminal stenosis at C5-6 bilaterally particularly on the right, but no additional high
grade stenosis is seen. There is no cord compression.
Nervous getting Monday the first ever cervical epidural but had 30 Lumbar my right shoulder is killing me worried about the dye Fluorosopy in the office
My doc refused to give me IV sedation for this. They gave me a Xanax which really didn’t help. I’ve always had IV sedation for every injection.
Why did my doctor do mine sitting down?
You guys need to go to fatih kirar in turkey. Turkey officially has the newest technology for herniated disc
Thank you so much! Just had my first this week. I wasn't told to take it easy, so I felt to good, I got out and mowed our 5 acre farm yard. Needless to say, I am paying for it the day after!!! Hope I haven't messed up anything.
I hope it ended up being alright! I can’t believe they didn’t tell you to take it easy ugh
How are you feeling down the track?
@@krupapatel8265 I’m supposed to have mine in one week. I’m pretty nervous. I keep seeing an add for a supplement which apparently will clear off the plaque buildup on nerve. Mylar sheath I’m trying to recall how it was named. Immediate response people were stating. Just a day or two later. 70$ a month …
I have mine at C6-c7 today. I am so nervous.
If there is any benefit it is usually short lived. Even though risks are small I don't feel the benefit if any outweighs the risk of these epidural procedures.
Why wasn't the injection needle placed directly into the C5-C6 epidural space? Is there increased risks with using the guide-wire type to advance to the correct level? Is there another video on "epigenetic changes"? Thank you for the great videos!
Sometimes it is easier to feed a catheter up
I just had injections yesterday on my Lumbar-hoping it works the pain is unbelievable
did it?
I just had mine today 3c4c epidural. I didnt need sedation only numbing of entrace area..March 11, 2024.. wasnt painful compared to the 6 weeks of horrible pain..waiting on insurance approval.
I had my third injection today.
No sedation necessary or requested. Absolutely no big deal and the relief I get is profound and complete. I could tell the day the previous injection wore off, 13 days ago. I went to OrthoSouth Acute Care in Memphis and was scheduled for another injection within the week. I’m very happy with my care and my results.
I’m a 61 year old fitness freak in great physical shape.
There’s no way you had this done without being numb
@@krichardson689They said no sedation, nothing about no numbing agent. They were awake when it was done.
Why so many ??? How long does it last all those times???
Opting for surgery at this point
My doc ordered this procedure for bulging C3 C4 - but I don't see how it would help or address the muscle loss and weakness / deterioration in my right shoulder area and infraspinatus, tricep and bicep
It is unlikely to address muscle loss but you should ask your doctor
I had this done about 10 years ago and it was so painful I was screaming but after it was over, it actually lasted 7 years! But it was so painful, I don’t think I could go thru that again unless they knock me out completely!
So maybe you could have taken oxycodone before (as NSAIDs are bad)? But did you scream during the procedure? I ask because I am getting an epidural for my neck in a few days and I don't want to be in such pain or move around during the procedure
Oh, hell to the NO. Are they doing t hos awake on me
Why are there no videos about the thoracic spine? I’ve already had laminectomies on T7 through T12, but can rarely find any information about that part of the spine.
I had no sedation and right after the procedure I was told I was done and could leave. I did get a headache from hello. But I never got any relief from the injection. And it felt like they were using a nail
Oh my gosh.... sounds like you should have gone somewhere like in this video. Sorry you had such a bad experience. Now I know what things to be looking for when I get mine. I hope for it to be as painless as this looks and that it works!
Best to try everything before jumping to surgery I guess 🤷🏻♀️
Feel better!
@Dr. Su, Is this a permanent fix or a temporary(How long will it last)? I really appreciate if you can give me an advice before I decide to go through the procedure. I'm having a cracking sound whenever I'm moving my neck and the doctor told me to go through the steroid injectionand no further informations given.
It takes the inflammation off of the nerve and sometimes that is all that is needed. However sometimes surgery is necessary. You can always call California orthopedics and spine for a virtual appointment with me
@@DrBrianSuTheSpineGuy Thank you so much Dr. Su.. Does it mean that the bone cracking sound will not be present anymore?
@@DrBrianSuTheSpineGuySurgery for neck is only when you have radial pain? Dr. .. can I take 5 or 10 mg of oxycodone before the surgery?
I'm getting a cervical interlaminar injection C7-T1 for a herniated disk and pinched nerve. I also get headaches when I sleep, for 5 years now, could this be from the pinched nerve?
It's very common to get cervical headaches from a pinched nerve
I’m going to be having this done soon and Dr. Oz had some doctor and they are saying this is the worst thing they could ever do to somebody because it’s so dangerous I don’t understand how it could be I hope not
Thanks Dr.Brian su for the informative video. Please, do you think if the patient get his pain improved 5 out of 10, he should repeat the injection within 6 weeks to get more improvement? Or he won't get more improvement than the first one?
Thanks, appreciate your @DrBrianSuTheSpineGuy
If the first one did help then a second one is likely to help as well I wouldn't do more than two.
@@DrBrianSuTheSpineGuy thanks Dr..appreciate
So I also need rib epidurals and having a pectoral botox injection h I w long in between can I have these done or should?
if they cant give you a general anesthetic, can they give you a bit of Valium or similar to calm the patient down? I also have several discs with pinched nerves, will this have to be done at each one? 2-3, 5-6, 6-7
Yes sedation can be used you should speak to your physician
Which is better, Nerve block or epidural? I got mild foraminal c6-c7
Watch the playlist cervical radiculopathy
I'd like to see Lumbar
Do you think these cervical ESI procedures are safe for patients with neck hyper mobility, hEDS, and MCAS?
They're not contradicated
@@DrBrianSuTheSpineGuy thank you, but if those patients also have a contrast allergy, would that compromise the safety of the procedure (to ensure medication does not accidentally get into a blood vessel)?
Mine never worked
I had 5 of them before my Dr. would schedule surgery. They didn't do a thing, are more painful than any surgery I ever went through and were a complete waste of money.
I had steroid trigger point injections that didn’t help much. I wonder why Kaiser did not recommend this type of injection considering how long I’ve been in pain..
They do nothing
I had this today and it was sooooo painful 😢
I got this procedure and the second injection, I experienced a shock down my left arm after inserting the needle. It caused excruciating pain in my nerves in my hand and arm. Today is day 3 of level 7 -8 pain. This is a risk my dr said can happen. It should go away on its own but the pain is terrible. More ppl should know about this risk.
It does get better. As a disclaimer please consult your surgeon.
@@MacchiatoSwirlGirl my hand is getting better but it’s such slow progress. I hope you don’t get this “risk” or “side effect”. I’m not in excruciating pain. More like a dull ache towards the end of day and early in the morning.
@Candace0730 hello.. any updates on your status?
@@BITTERSWTIZ28 Hi! I plateaued at about 5%. I can always feel a slight sensation in my left wrist. Still a very small shock under hot or cold water. I need to take the B Complex vitamin daily and see if that helps. I’m used to it now. 🫤. Makes me leery of any future medical procedures now.
Just had my 4th procedure. The 3rd last over 2yrs til another accident mess me back up.
Jeez man, I’ve had 3 as well and a facet another accident is detrimental.
My mom gets that for spinal stenosis but it’s not helping anymore 😢I should bring my mom to see you we live in Fremont ca
Yes we are happy to help. You can call 415-925 8200 for a second opinion
These Injections are not FDA APPROVED, what do you say to this ????
There are many things we do in science that are off label by the FDA but still are effective
Can't do caffeine
I’ve got injection on 1st July but worried about lying face down on table because I’m claustrophobic,is there anyway around that can I have it done sitting up
It would be too hard to image
Is there another way of having it done because even the thought of lying face down with things over my head makes me shive thinking about it
i’ve had about 12 of these over the years. I have never had any anesthesia of any kind. The doctor says that about 10% of his patients don’t want and I don’t either. It’s not a big deal.
Without local anesthesia, would it be ok to take 5 to 10 mg of oxycodone for the pain of the procedure and afterwords?
Yes but you need to consult your spine surgeon
@@DrBrianSuTheSpineGuyThanks a lot.
I have a c6-c7 scheduled today...severe compression, but also scared I will feel more pain when the nerves are not compressed, I also have 3 rotator cuff tears in my right shoulder...uhh
extremely extremely.....Can an incorrect cervical epidural nerve block cause cardiac arrest? Can there be side effects such as cerebral hemorrhage even after a normal procedure? please help me
any answer? please
I need to get it done asap. But the problem is I am unable to lie down not even 5 minutes. When I lie down my left hand wrist feels like someone is crushing my bone. If I wait a while will I be able to lie down still?
Yes
Why do some doctors not give a local?
Almost all doctors give local
How does this help a pinched nerve? I'm set to get one soon if my insurance pays for it.
It takes the inflammation off of the nerve
@@DrBrianSuTheSpineGuy - Thanks!
I am scheduled to have my first epidural injection in my cervical spine in a couple of weeks. I have Cervical stenosis and radiculopathy from C4-C7. I also have muscle weakness and have done PT but the radiculopathy came back with a vengeance a couple of weeks ago. My Spine Surgeon is recommending this to get the pain and inflamation under control as medication hasn’t worked for me. Does the epidural improve muscle weakness or just pain and inflammation? He is recommending a Three level fusion sooner rather than later. I have seen many of your videos and they’re excellent and so informative. Thank you so much!
I'm Having one done Friday Morning at the Hospital and there going to put me to sleep question is do they put a heart monitor on you ?
Every hospital is different sometimes they do
They called and told me what there doing
@@DrBrianSuTheSpineGuy
Dr. I took epidural steroid injection last week for back pain . After 2 dys I'm getting continuous urination . Is it normal
You should consult a person you had the epidural from
I love any type of nerve block or injection in my neck & back. It feels so good going in. No numbing medicine needed & I’m off to work when the procedure is done.
What happened to doctors because at the beginning of my nightmare with my spine we were told you couldn’t do anymore than 2 a year six months apart then I found out that the FDA did not approve of these injections, because so many people were injected into the spinal cord. These things do not help out with the damage of these nerves at all, and especially if you have stenosis, or any other kind of diseases within your spine.
do u put them asleep before
doing it ?
They get sedation
I am having put to sleep cos i have serious anxiety
Doctor Su, have you ever performed an epidural (either cervical or lumbar) and the patient got no pain relief at all?
Correct not everybody gets relief from an epidural
I disagree with the doctor on the epidural headache ive had one and caffeine nor medicine stops it. They sid a blood patch and it stopped it. Im supposed to have a cervical epidural this video makes me nervous to have it done.
I eat my words lol.I had my first one ever today! It's been 5 hours now (1/2/24)
This procedure isn't FDA approved so I am curious why keep doing it? 🤔
There are many things that are off label that can be effective
This sounds like it's best for patients who have a chance at healing while they're under the affect of the corticosteroid. The corticosteroid's time in affect will vary from patient to patient.
I am not a patient who will heal during the time that the steroid is in affect, so should I take what you're saying to mean that I'm not actually a good candidate for this type of injection?
Steroids have different effects in different people.
I had one. Never again !!! Very very painful and did not help even a little bit 😢
Yikes! That usually means that surgery won't help either. Best of luck to you! Maybe they missed the nerve? Wonder if they used that guidance and dye to make sure they were in the right spot?
Feel better, nothing is worse than back pain!
Mine was very painful too!! I was also sitting up. Most of pain between the shoulder blades but bandage was at my neck where T1 is stenosis C6-C3
Could this be done without CONTRAST??? IM ALLERGIC TO IT
I am too
You have patients live with the pain? I really hope you meant something else by that and I just didn’t understand what you meant. Would you want to live with the pain? I was all for this video until you said that.
Many people choose to live with a certain level of pain. For example many people have a good quality of life with a pain level of 2 out of 10. But when pain gets worse they cannot live with it and choose to do so something else like an injection or surgery.
@@DrBrianSuTheSpineGuy ok, I wish you had stated that instead. It came out wrong. I do know people who live with some degree of pain and don’t want surgery. I had no options left and had to resort to surgery. And it failed, so I still live with a high level of pain. I am with a pain management Dr who listens when they want to, unfortunately. I have my good and bad days. Thank you for correcting what you said. I don’t wish my level of pain off on anyone. I handle pain every day that would put most people on their knees and I’m 39. I hope and pray you can continue to help people stay out of the OR. Unless they’re getting injections. God Bless you and thanks again for correcting what how you said that. I appreciate you responding.💪
Just tell us to secret that's all.
Absolutely not
Epidural is dangerous!! Do not do it!!! Oct 2023 had headache not getting better after 3 months..
yeeahhh, no thanks. I'll stick with ibuprofen and destroy my stomach.
No don't be scared..I had 3 injections in my lumbar and now I'm at the gym in after 15 yrs.. Today I got my first neck injection 5 hrs ago with no pain, (at least yet).
@@kennethfinch3629 thanks for the kind words of encouragement. I was actually fortunate to get a lot of relief from just cervical traction therapy. Still not a 100% but haven’t taken ibuprofen or iced my neck in close to a month.
Perfect video for me I am totally addicted to those kind of videos thumbs up. You should look into using a service such as Promo-SM!!!