Lumbar & Thoracic Interlaminar Epidural Steroid Injections

What Is a Lumbar or Thoracic Interlaminar Epidural Steroid Injection?

A lumbar or thoracic interlaminar epidural steroid injection is a minimally invasive, image-guided procedure used to reduce inflammation and relieve pain caused by irritated spinal nerves in the mid-back (thoracic spine) or lower back (lumbar spine).

The epidural space surrounds the spinal cord and nerve roots. When a disc bulges, degenerates, or when arthritis narrows the spinal canal, nearby nerves can become inflamed. This may lead to:

• Mid-back or low back pain

• Pain radiating into the chest wall or ribs (thoracic)

• Sciatica or leg pain (lumbar)

• Numbness or tingling

• Inflammatory nerve irritation

An interlaminar epidural injection delivers anti-inflammatory medication into the central epidural space to calm inflammation across a broader region of irritated nerves.

How the Procedure Works

The term interlaminar refers to the approach used. The needle is placed between the laminae, the bony structures on the back of the vertebra, allowing medication to enter the epidural space centrally.

During the procedure:

1. You lie comfortably on an X-ray table.

2. The skin is cleaned and numbed.

3. Using live X-ray guidance (fluoroscopy), a thin needle is carefully advanced into the epidural space.

4. Contrast dye confirms proper placement.

5. A corticosteroid (anti-inflammatory medication), often combined with local anesthetic, is injected.

The procedure typically takes 15–30 minutes and is performed on an outpatient basis. Most patients return home the same day.

When Is This Approach Used?

Interlaminar epidural injections are often chosen when:

• Pain involves multiple nerve levels

• Symptoms are more central or bilateral

• There is spinal stenosis

• There is inflammatory pain without a single clearly isolated nerve root

• A broader distribution of medication is desired

In the lumbar spine, this approach is commonly used for low back pain with leg symptoms. In the thoracic spine, it may help with mid-back pain or radiating rib/chest wall discomfort related to nerve irritation.

Conditions Treated

Lumbar and thoracic interlaminar epidural injections may be recommended for:

• Lumbar or thoracic disc herniation

• Spinal stenosis

• Degenerative disc disease

• Radiculopathy (nerve pain)

• Post-surgical inflammation

• Central canal narrowing

These injections are typically considered after conservative treatments such as medications, physical therapy, and activity modification have not provided sufficient relief.

What to Expect After the Injection

You may experience temporary relief shortly after the procedure due to the local anesthetic. The steroid medication may take several days to reach full effect.

Pain relief may last weeks to months, depending on the underlying condition. For many patients, the goal is to:

• Reduce inflammation

• Improve mobility

• Allow participation in rehabilitation

• Decrease reliance on oral medications

• Delay or avoid surgery when appropriate

Response varies from person to person.

Risks and Safety

When performed by experienced spine specialists using imaging guidance, interlaminar epidural injections are generally safe.

Potential risks include:

• Temporary soreness at the injection site

• Temporary increase in pain

• Headache

• Elevated blood sugar in diabetic patients

• Bleeding or infection (rare)

• Nerve irritation (rare)

Careful technique and imaging guidance significantly reduce complication risk.

How Often Can These Injections Be Performed?

Steroid exposure is monitored carefully. Most patients receive a limited number of injections per year depending on their condition, response to treatment, and overall health profile. Your physician will individualize your treatment plan accordingly.

Our Approach

At our clinic, interlaminar epidural injections are used strategically, not as a routine reflex treatment, but as part of a thoughtful, individualized care plan. We focus on identifying the true pain generator and selecting the injection approach (interlaminar vs. transforaminal) that best matches your anatomy, imaging, and symptoms.

The goal is not simply temporary relief, it’s restoring function and improving quality of life.

Reference

Educational content adapted from Cleveland Clinic and peer-reviewed interventional spine resources:
https://my.clevelandclinic.org/health/treatments/17341-epidural-steroid-injection