[Through the foramen to the nerve root : The new S3 Guideline Epidural Injections].

Abstract

Background: In a transforaminal injection, medication is administered to a nerve root through the neuroforamen. Since the position of the nerve root is intradural, the target is the epidural space. Anti-inflammatory medication is usually used.

Radicular complaints: In the case of radicular complaints caused by a herniated disc, there is a high level of evidence for the effectiveness of epidural injections. The needle position (supra- or infraneural) must be checked using imaging. The gold standard is fluoroscopy, but CT can also be used. The use of a non-particulate steroid is preferable due to the lower risk potential. The injection of a steroid into the epidural space is always an off-label therapy. After an intervention, it is necessary to examine the patient neurologically. It is only after 4 days that it is possible to assess whether long-term success has been achieved. A transforaminal injection can be repeated if a positive effect was achieved beforehand.