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Updated: Jul 7, 2026
03:14
Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
Published on: January 31, 2025
Lumbar Epidural Steroid Injection Approaches: A Practical Overview for Trainees
Jamal Hasoon1, Joey Hung2, George Atallah1,3
1Department of Anesthesiology, Critical Care, and Pain Medicine The University of Texas Health Science Center at Houston.
Orthopedic Reviews
|July 6, 2026
Summary
Lumbar epidural steroid injections (ESIs) offer targeted pain relief for spinal disorders. This review details interlaminar, transforaminal, and caudal ESI techniques, highlighting their unique benefits and applications.
Area of Science:
- Pain Management
- Interventional Radiology
- Neurosurgery
Background:
- Lumbar epidural steroid injections (ESIs) are frequently used for spinal pain.
- Three main approaches exist: interlaminar, transforaminal, and caudal.
Purpose of the Study:
- To review key teaching points of each lumbar ESI technique.
- To illustrate procedural views with fluoroscopic images.
Main Methods:
- Review of interlaminar, transforaminal, and caudal epidural injection techniques.
- Inclusion of representative fluoroscopic images.
Main Results:
- Interlaminar ESI: broad epidural spread, suitable for multilevel pathology.
- Transforaminal ESI: targeted delivery, diagnostic potential for nerve root pain.
- Caudal ESI: useful for altered anatomy, favorable safety profile.
Conclusions:
- Each lumbar ESI approach has distinct advantages and limitations.
- Understanding technique variations is crucial for effective pain management.
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