Steroid (Cortisone) Injection in the Cervical Spine

Cervical Epidural Steroid Injection

Dr. Samer Abdel-Aziz

One of the procedures we perform to treat neck pain radiating to the arm due to nerve root compression in the cervical spine is steroid (cortisone) injection around the nerve roots in the neck.

What is this procedure?

This procedure involves injecting a small amount of anti-inflammatory medication and a local anesthetic into the cervical spine around the spinal cord and nerve roots. It is used to treat neck pain radiating to the arm caused by nerve root compression in the spine, which may result from either a herniated disc or spinal stenosis, where the spine narrows and puts pressure on the nerve roots.

Injecting the medication into the spinal canal can help alleviate pain by reducing the chemical substances responsible for inflammation or pain. Patients may experience relief from the first procedure, and it may be necessary to repeat the injection two or three times, depending on the severity of the condition. In some cases, no improvement occurs, and surgery may be needed if the condition does not improve with non-surgical treatments.

How is the procedure performed?

In our interventional procedure room, you will be assisted in lying on your stomach on the operating table. The neck area will be sterilized, and the skin will be numbed with a local anesthetic. Then, using fluoroscopic (X-ray) guidance, a needle is inserted to the precise target area in the spine. Once the exact location of the needle is confirmed, the medication is injected, and the needle is removed.

What to expect after the procedure?

After the procedure, a nurse will guide you to your room and provide post-procedure instructions.

Improvement may not be immediate, and you might start noticing relief after a few days. In some cases, there may be no improvement, and further interventions might be required. The nurse will follow up with you after a few days to check on your progress and offer any additional advice you may need.

Are there any risks associated with this procedure?

Like any medication or medical procedure, there are risks, but in general, this procedure is considered safe, with very minimal chances of complications. Potential risks include:

  • Low blood pressure and nausea
  • Spinal bleeding
  • Nerve damage or paralysis (very rare)
  • Headache
  • Increased pain

For pregnant women, there is a risk to the fetus due to the use of X-ray guidance, so the procedure will be postponed until after delivery. If you are taking blood thinners, these medications will be stopped before the procedure to reduce the risk of bleeding.

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