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Procedures

Spinal Injection Procedures

What Are Spinal Injection Procedures?

Spinal injection procedures are performed in order to both diagnose and treat different causes of back pain. There are multiple different types of spinal injection procedures; the most commonly performed procedures include epidural injections, selective nerve blocks, and facet joint injections. The type of injection you receive is determined by your doctor based on your symptoms and the results of other imaging studies such as lumbar spine CT or MRI.

How Should I Prepare?

You will be asked not to eat for 6 hours prior to the procedure. You may have clear liquids up to 2 hours before the procedure but should eat nothing after that.

If you are taking prescribed anticoagulants (blood thinners) such as Coumadin or Plavix, you should ask your physician for instructions prior to the procedure. Patients should not take over-the-counter aspirin or aspirin-containing medications for at least 5 days prior to their procedure. Please consult with your doctor or healthcare provider before stopping ANY medications.

Please arrive for your procedure with a responsible adult who can drive you home.

What Should I Expect?

After you arrive for your appointment, you will be escorted to a procedure room, where you will be asked to change into a patient gown. You will be positioned on an exam table, and fluoroscopy will be used to determine the most appropriate needle entry site. The radiologist will cleanse the overlying skin, and a small amount of local anesthetic (lidocaine) will be injected with a small needle.  You will feel a tiny pinch similar to a pinprick while the anesthetic is injected.

After the area becomes numb, the radiologist will insert a needle and advance it to the appropriate location while observing under fluoroscopy.  This may reproduce your usual symptoms.  A small amount of contrast material will be injected to confirm the needle is in the proper location.  A mixture of a steroid medication and an anesthetic agent will then be injected, which often produces an immediate improvement in symptoms. The needle will then be removed.  A bandage will be placed over the insertion site, and you will be transported to the recovery area.

After being monitored for a short time, you will be released with discharge instructions. The entire procedure usually takes about 45-60 minutes.  Prior to discharge you will be given a pain log, which you should take home with you and use to record any changes in your symptoms. You should bring the pain log with you when you follow up with your regular doctor.

The contrast agent that is used during the procedure is an iodine-based material. Radiology Ltd. uses only non-ionic contrast agents (the safest kind), but with all contrast agents there is always the potential for allergic reaction. Be sure to tell your technologist if you have experienced a reaction to CT contrast in the past.

For your safety and the protection of others, we do not allow anyone other than patients in our exam rooms.

Are There Potential Side Effects or Complications?

Significant complications related to spinal injection procedures are very uncommon. The primary risks associated with this procedure include:

  • Bleeding
  • Infection
  • Allergic reaction to the contrast material

Most spinal injection procedures are very well tolerated, with minimal discomfort afterwards that is usually easily controlled with non-prescription pain medication. You may apply ice to the needle insertion site to reduce swelling if necessary. Symptoms usually disappear within 48 hours; contact your physician or healthcare provider if they persist for more than two days.

How Do I Get the Results?

A final report describing the procedure will be sent to your doctor or healthcare provider.

Reports are also available on the MyRAD Patient Portal

Pain Management Team

Bradley J. Bohnert, M.D.

  • Specialties:
    Neuroradiology
  • Education:
    B.S. – Harvey Mudd College (Claremont, California), 1988
    M.D. – University of California at Los Angeles, 1993
    M.B.A. – George Washington University (Washington, DC), 2012
  • Internship:
    Internal Medicine, Good Samaritan Regional Medical Center (Phoenix), 1993-1994
  • Residency:
    Diagnostic Radiology, University of Colorado, 1994-1998
  • Fellowship:
    Neuroradiology, Barrow Neurological Institute, 1998-2000
  • Board Certifications:
    ABR 1998; CAQ Neuroradiology 2000, 2010

With Radiology Ltd. since 2000

Taylor P. Chen, M.D.

  • Specialties:
    Neuroradiology
  • Education:
    B.S. – University of California at Los Angeles, 1992
    M.D. – University of Southern California, 1996
  • Internship:
    Internal Medicine, Santa Barbara Cottage Hospital, 1996-1997
  • Residency:
    Diagnostic Radiology, Duke University, 1997-2001
  • Fellowship:
    Neuroradiology, Barrow Neurological Institute, 2001-2003
  • Board Certifications:
    ABR 2001

With Radiology Ltd. since 2003

J. Anthony Lee, M.D.

  • Specialties:
    Neuroradiology
  • Education:
    B.S. – Arizona State University, 1991
    M.D. – University of Texas Southwestern (Dallas), 1996
  • Internship:
    Transitional, Mayo Clinic (Scottsdale, Arizona), 1996-1997
  • Residency:
    Diagnostic Radiology, Stanford University, 1997-2001
  • Fellowship:
    Neuroradiology, Barrow Neurological Institute, 2001-2003
  • Board Certifications:
    ABR 2001

With Radiology Ltd. since 2004

Meet Jessica, Tucson native

In 2005 Jessica injured her back and was in a lot of pain. She had an MRI at Radiology Ltd. that revealed a disc herniation that was pinching one of the nerve roots in her back. Dr. Bohnert performed a nerve block in Tucson on Jessica after other therapies had little effect.  “The procedure was a huge success. I am now living pain-free!”