Cervical Interlaminar Epidural Steroid Injections (ILESI)

What Is a Cervical Interlaminar Epidural Steroid Injection?

A cervical interlaminar epidural steroid injection is a minimally invasive treatment used to help manage chronic neck pain and symptoms that radiate into the shoulder or arm. This procedure delivers anti-inflammatory medication into the epidural space, the area surrounding the spinal cord in the neck, to reduce swelling and calm irritated spinal nerves.

The cervical spine consists of seven vertebrae (C1–C7) that protect the spinal cord and allow movement of the head and neck. When nerve roots in this region become compressed or inflamed, such as from a herniated disc, degenerative changes, or spinal stenosis, pain may develop and radiate down the arm. Cervical epidural steroid injections aim to decrease that inflammation and improve comfort and function.

How the Procedure Works

An interlaminar approach delivers medication through a small opening between the laminae — the flat bony plates on the back of each cervical vertebra, into the central epidural space. This allows the steroid medication and, in many cases, a local anesthetic to surround the spinal nerves where they exit the spinal canal.

Here’s what typically happens:

• You lie face down on an X-ray table.

• The skin is cleaned and numbed with a local anesthetic.

• Using real-time imaging (fluoroscopy), your physician carefully guides a thin needle into the epidural space between the laminae.

• The medication is injected around the affected nerves to reduce inflammation.

The injection usually takes 15–30 minutes and is performed on an outpatient basis. Afterward, you can go home the same day.

Conditions Treated

Cervical interlaminar epidural steroid injections may be recommended for patients experiencing pain due to:

• Cervical radiculopathy (nerve irritation in the neck)

• Herniated or bulging discs

• Degenerative disc disease

• Spinal stenosis (narrowing of the spinal canal)

• Chronic neck pain that radiates to the shoulder or arm

By reducing inflammation around the nerve roots, these injections can improve pain control and support participation in physical therapy and rehabilitation.

What to Expect After the Injection

Patients may notice immediate relief from the local anesthetic, followed by a gradual reduction in inflammation as the steroid begins to work over several days. Pain relief can last from a few weeks to several months, though individual responses vary.

Some patients may require a series of injections spaced over time, depending on symptom severity and response. This approach is often part of a comprehensive management plan that includes physical therapy and lifestyle modifications.

Risks and Side Effects

Cervical interlaminar epidural steroid injections are generally safe when performed by trained pain specialists using imaging guidance. However, as with any invasive procedure, there are potential risks. These may include:

• Temporary soreness or discomfort at the injection site

• Headache or dizziness

• Transient numbness or tingling

• Elevated blood sugar in patients with diabetes

• Rare risks such as infection or bleeding

Serious complications are uncommon but should be discussed with your physician before treatment.

Who Is a Good Candidate?

This injection may be considered when:

• Neck and arm pain are affecting daily function

• Conservative treatments (medication, physical therapy) have not provided sufficient relief

• Imaging shows nerve irritation or inflammation consistent with symptoms

Your clinician will review your medical history, imaging findings, and goals before recommending this option.

Reference

Adapted with permission from Cleveland Clinic:
Cervical Epidural Steroid Injection.
https://my.clevelandclinic.org/health/treatments/22293-cervical-epidural-steroid-injection