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Surgical Center FAQ
  Frequently Asked Questions  
  Q: What is an epidural steroid injection?  
  A: An epidural steroid injection is an injection of an anti-inflammatory medication known as corticosteroids into the epidural space, which is the area surrounding the nerve roots within the spinal column.  
  Q: What is the purpose of an epidural steroid injection?  
  A: The corticosteroids reduce inflammation or swelling of nerves in the epidural space. This may in turn reduce pain, numbness or tingling, or other symptoms resulting from nerve root inflammation.  
  Q: How long will the injection take?  
  A: Generally the injection takes less than fifteen minutes.  
  Q: What is injected into the epidural space?  
  A: The injection consists of a mixture of a local anesthetic such as lidocaine and the corticosteroids (Triamcinolone, DepoMedrol or Celestone Soluspan). A liquid dye is also used to confirm the appropriate injection site in the epidural space.  
  Q: Is the injection painful?  
  A: There is slight discomfort involved with an epidural cortisone injection. Most of the pain is minimized following the administration of a local anesthetic, which numbs the skin and deeper tissues. Most patients tolerate the procedure very well.  
  Q: Will I be “put out” for the procedure with a general anesthetic?  
  A: No. Most epidural injections in the spine are done under local anesthesia. In general, there is no need to receive intravenous sedation. However, some patients that are anxious about the procedure may require intravenous sedation.  
  Q: How is the injection performed?  
  A: The injection is generally done with the patient lying on their chest and stomach on a procedure table. The procedure utilizes a fluoroscope, which is a device that provides an image used during the procedure to appropriately guide placement of the needle into the epidural space. Use of the fluoroscope makes the procedure safer and more effective.  
  Q: What should I expect after the injection?  
  A: Most patients will feel normal immediately after the procedure. Occasionally, patients will experience transient numbness or weakness in their extremities due to the anesthetic. This lasts only a few minutes. The patient’s usual pain may return the day of the procedure. The corticosteroid medication in general does not provide pain relief until the third day following the procedure.  
  Q: What should I do after the procedure?  
  A: Unless special arrangements are made prior to the procedure, patients should have a driver to take them home. We advise patients to take it easy for one or two days following the procedure and perform activities as tolerated.  
  Q: Can I go back to work the next day?  
  A: In most cases patients can return to work the following day.  
  Q: How long will the effect of the corticosteroids last?  
  A: The positive response to the corticosteroid medication varies in all patients. Some patients may have relief for only a few days following the procedure. However, many patients achieve pain relief following the injection that lasts for months or even years.  
  Q: How many injections do I need to have?  
  A: If the first injection does not provide adequate pain relief, then a second or third injection may be required. In general, the additional injections are performed one to two weeks following the last injection.  
  Q: Can I have more than three injections?  
  A: Generally we do not perform more than three injections in a six month period. Under special circumstances, some patients may receive more than three injections in one year.  
  Q: Will the epidural cortisone injection help me?  
  A: It is very difficult to predict if the injection be successful. Generally, patients who have radiating pain into the arms or legs respond better to the injection than patients who only have back or neck pain. Similarly, patients with a recent onset of pain may respond more favorably than patients with longstanding pain.  
  Q: Does the steroid injection reduce the size of the disc herniation?  
  A: No. Corticosteroid epidural injections reduce nerve root inflammation. They do not change the size or configuration of disc herniations.  
  Q: What are the risks and side effects?  
  A: Generally speaking, this is a very safe procedure. The most common side effect would be an increase in pain, which is temporary. Other risks may include spinal puncture with headaches, infection and bleeding. Corticosteroids are also associated with flushing, weight gain, elevated blood sugar, water retention and suppression of the body’s immune system. However, these side effects are rare when corticosteroids are given in appropriate doses.  
  Q: Who should not have this injection?  
  A: Patients who are allergic to any of the medications that are injected. Also, patients who are on blood thinners such as Coumadin, Plavix or large doses of aspirin should not have the injection. Patients that have an active or ongoing infection should not have the injection.  
  Q: Will my surgical procedure be covered by my insurance company?  
  A: Landmark Imaging Surgical Center, LLC is not contracted with any insurance company, with the exception of Medicare. Our outside billing company, Medical Specialties Managers, Inc., will submit the claim to your insurance provider and will work with you to minimize any out-of-pocket expense that may occur.  
  For further clarification, you may contact your insurance company or our billing company at (888) 598-8820 Extension 1. Their billing office hours of operation are 9:00 am-4:00 pm PST Monday through Friday.  

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