Lumbar Nerve Root Injection

WHAT YOU SHOULD KNOW:

• A lumbar (LUM-bahr) nerve root injection is a procedure to inject medicines at the nerve roots of your lumbar (lower back) spine (backbone). This procedure is done to decrease inflammation (swelling) and pain from the damaged nerve roots. It may also be done to relieve pain caused by other conditions of the lumbar spine. These conditions may include stenosis (narrowing) or spondylosis (abnormal wear of the cartilage and bones of the spine). These conditions may all cause long-standing pain in your lower back, buttocks, or legs. The spine is made up of bones called vertebrae that are like blocks placed on top of each other. The spine protects the spinal cord, and nerves coming to and from the spinal cord. A nerve root is a bundle of nerve fibers found just as the they leave the sides of the spine.
  
  
• During the procedure a thin needle is inserted along the lumbar spine to the affected nerve root. Your caregiver will first inject a small amount of anesthesia (numbing medicine). He may then inject medicine for inflammation. With a lumbar nerve root injection, your long-standing back or leg pain may be treated, and you may resume your usual activities.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

Having a lumbar nerve root injection may carry certain risks, such as infection and bleeding. Other parts near your spine, such as nerves, blood vessels, ligaments, muscles, and bones may be damaged. The medicines may spread in areas near the lumbar nerve root and cause numbness in these areas. Even after a successful procedure, you may still have leg or lower back pain. If left untreated, the pain and problems you have will continue to be there and may even get worse. You may have trouble going back to your usual activities. Call your caregiver if you are worried or have questions about your procedure, medicine, or care.

GETTING READY:

The week before your procedure:

• Ask a family member or friend to drive you home after your procedure. Do not drive yourself home.
  
  
• Tell your caregiver if you have any allergies. These include allergies to food, dye, cleansing solution, such as iodine, or any numbing medicine.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your procedure. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before the procedure. You may need to check your blood sugar more often before and after having your procedure.
  
  
• If you are a woman, tell your caregiver if you know or think you are pregnant.
  
  
• You may need to have different blood and urine tests. Imaging tests, such as x-rays, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) may also be done. Write down the date, time, and location of each test. Ask your caregiver for more information about these and other tests that you may need.

The night before your procedure:

• Remove any nail polish.
  
  
• You may be given a pill to help you sleep.
  
  
• Ask caregivers about directions for eating and drinking.

The day of your procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• What to bring: You may want to bring items such as a toothbrush and bathrobe.
  
  
• Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.
  
  
• You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Be sure all your questions have been answered before you sign this form.

TREATMENT:

What will happen:

• You will be asked to change into a hospital gown. You will be given medicine to help you relax or make you drowsy. You will be taken on a stretcher to the room where the procedure will be done. You will be asked to lie on your stomach, with your body slightly turned to the side. A pillow may be placed under your belly or you may be asked to bend one or both knees. Your back will be cleaned and covered with sheets to keep the procedure area clean. A medicine called local anesthesia will be given to help control pain during the procedure.
  
  
• During the procedure, a thin needle will be inserted near your lumbar spine to the affected nerve root. Your caregiver will use an x-ray with dye or a computerized tomography (CT) scan to help guide the needle. He will place the needle tip very near the nerve root. Once the needle is placed properly, your caregiver will inject medicines like steroids (medicine for inflammation) and long-lasting anesthesia. Your caregiver may insert another needle and inject medicines in other problem areas. After the procedure, the areas where needles were inserted will be covered with bandages.

After your procedure: You may be taken to a recovery room to rest. Caregivers will watch you closely for any problems. Do not get out of bed until your caregiver says it is OK. When caregivers see that you are OK, you will be taken back to your hospital room. The bandages keep the area clean and dry to prevent infection. A caregiver may remove the bandages soon after your procedure to check your wound.

Waiting room: This is a room where your family and friends can wait until you are ready for visitors. If your family leaves the hospital, ask them to leave a phone number where they can be reached.

CONTACT A CAREGIVER IF:

• You cannot make it to your appointment on time.
  
  
• You have a fever (increased body temperature).
  
  
• You have a skin infection or an infected wound near your lower back.
  
  
• You have questions or concerns about your procedure.

SEEK CARE IMMEDIATELY IF:

• The problems for which you are having the lumbar nerve root injection get worse.
  
  
• You have a lot more pain or discomfort.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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