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BackTable / MSK / Podcast / Episode #55
BackTable Basics: Lumbar Epidural Injections
with. Dr. Chris Beck
An epidural steroid injection (ESI) is a minimally invasive technique used to treat back pain. Providers from various specialties and settings can learn and offer this procedure. In this episode of the Back Table MSK Podcast, hosts Jacob Fleming and Chris Beck share their experiences and techniques for performing ESIs.
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BackTable, LLC (Producer). (2024, August 6). Ep. 55 – BackTable Basics: Lumbar Epidural Injections [Audio podcast]. Retrieved from https://www.backtable.com
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Podcast Contributors
Dr. Christopher Beck
Dr. Chris Beck is a practicing interventional radiologist with Regional Radiology Group in New Orleans.
Dr. Jacob Fleming
Dr. Jacob Fleming is a diagnostic radiology resident and future MSK interventional radiologist in Dallas, Texas.
Synopsis
The doctors detail the technical aspects of their ESI procedures, including guidance on patient and C-arm positioning, considerations for an interlaminar approach, and potential complications to watch for.
Timestamps
00:00 - Introduction
03:41 - Learning How to Perform ESIs
06:58 - Common Indications for ESIs
10:49 - Dr. Beck’s Technical Approach
32:22 - Dr. Fleming’s Technical Approach
40:49 - Treating Intrathecal Complications
Resources
Atlas of Image-Guided Spinal Procedures (Furman et al, 2018):
https://shop.elsevier.com/books/atlas-of-image-guided-spinal-procedures/furman/978-0-323-40153-1
Transcript Preview
For sure. I'm glad you brought that up because, that actually brings up, I think the differentiation between a chronic and more subacute presentation. I'm sure you've had these patients who they present and they have just terrible sciatica. One of the things that I've learned is that sciatica is one of those types of pain that really can be a 10/10. I also put up there vertebral compression fractures and just a few other things. Usually when a patient comes to you and they're just having terrible pain, there's a very good possibility that it's an acute or subacute disc herniation. That could definitely be compressing the nerve in a lateral recess or the foramen.
Bone cement: Serious adverse events, some with fatal outcome, associated with the use of bone cements for vertebroplasty, kyphoplasty and sacroplasty include myocardial infarction, cardiac arrest, cerebrovascular accident, pulmonary embolism and cardiac embolism. Although it is rare, some adverse events have been known to occur beyond one year post-operatively. Additional risks exist with the use of bone cement. Please see the IFU for a complete list of potential risks.
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
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