IESI (interlaminar epidural steroid injection) is a minimally invasive outpatient procedure used to help decrease inflammation and irritation of the nerve root or herniated disc. They have been used for years to treat cervical, back, and radicular pain caused by bulging discs, sciatica, vertebral compression, or other issues.
Unlike a transforaminal epidural steroid injection, an IESI tends to have a broad spread. This spread is capable of covering up to four levels in the spine. This spread is achieved by targeting the “interlaminar window.”
What Does an IESI Treat?
The conditions best treated by an IESI are ones that are known to cause inflammation, which is what is targeted. Inflammation within the spine is a condition that is treated very effectively by IESI. The inflammation is caused by numerous issues, mechanical or physiological. This inflammation irritates the surrounding nerves, causing acute and/or radicular pain. For example, if neck pain is felt traveling down the arms, and if back pain is felt traveling down the legs.
There are also many instances of inflammation-causing muscular pain and tightness. This tends to happen because the body knows something is wrong, which is why inflammation is signaled for. The signaling of inflammation can also signal the muscles around the area to tense up or shut down.
How Does an IESI Treat Inflammation?
Most IESIs involve a solution that contains a corticosteroid and a local anesthetic. The injection tends to be indirect, attempting to avoid pressuring or inflaming the target area. This indirect approach involves the use of x-ray fluoroscopy imaging and contrast.
Physicians use fluoroscopy to ensure they are in the right area and then further confirm the spread of the medicine by first injecting a small amount of contrast. Once the desired spread and area are confirmed, the corticosteroid and local anesthetic solution is injected.
The corticosteroid suppresses collagen-producing cells, reducing overall inflammation in the blanketed area. The local anesthetic helps by calming the nerves in that area down, further decreasing pain. This reduction in inflammation allows the muscles and other joints to “reset,” alleviating irritation.
What is the Effectiveness of an IESI?
Since the IESI is meant to battle inflammation, more than one injection may be required. Sometimes, the injected steroid is outmatched by the present inflammation, leading to a second or third set of injections. When the inflammation is washed out and the pain subsides, patients tend to have about six months of relief.
Physical therapy is usually prescribed after the injections to further aid in pain relief and build up the surrounding muscles to help decrease the stress on the inflamed area.
Who Performs Interlaminar Epidural Steroid Injections?
Interventional spine and pain specialists tend to be the physicians performing an IESI. Here at Cantor Spine Center at the Paley Orthopedic & Spine Institute, Drs. Giuffrida and Westerhaus are expert physicians in performing successful steroid injections.
If you’d like to learn more about interlaminar epidural steroid injections, or you would like to schedule a consultation to see if IESI is right for you, call (954) 567-1332 or our Contact Us page to schedule an appointment.