A cervical epidural steroid injection (CESI) is a minimally invasive image guided therapeutic injection that is performed to relieve neck pain and radiating upper limb symptoms. Through the available research and clinical experience, this procedure has been demonstrated to: improve pain and function, break the pain cycle, and decrease inflammation of the target structures. Importantly, this image guided treatment allows the delivery of a concentrated volume of therapeutic medication directly to the site of injury/inflammation, which increases the probability of optimal effectiveness while minimizing the risk of systemic side effects (especially compared to oral medications).
How is a CESI performed?
The patient lies face down, with a pillow underneath the chest and the neck slightly flexed, and forehead resting on the procedure table.
A local anesthetic is utilized to numb the skin, as well as to numb the tissue from the skin to the spine.
Using a fluoroscope for guidance (live X-ray guidance), the physician carefully directs the therapeutic needle to the target epidural space. Once the needle tip is confirmed to be in the target epidural space using multiple techniques including the aforementioned image guidance, a contrast solution is injected to ensure that the therapeutic medication will ultimately flow in the desired path to treat the target tissue.
The therapeutic medication injected includes a steroid medication (typically Dexamethasone, which is one of the strongest anti-inflammatory pain medications available for safe treatment of spine conditions), which is injected into the target epidural space and bathes the target inflamed/injured tissue.
End of Procedure
The therapeutic needle is carefully removed, and a small sterile bandage is applied to cover the small needle surface wound.
How long does it take for the CESI to work?
Typically it takes about 3-7 days for the full therapeutic effect of the CESI.
Who performs a CESI?
CESIs are performed by one of the board certified Interventional Pain Physicians at Spine & Nerve Diagnostic Center (SNDC). Our interventional physicians have performed thousands of these procedures.
Where are CESIs performed?
CESIs are typically performed at one of our state of the art SNDC procedure suites.