Thoracic Interlaminar Epidural Steroid Injection
Injections of local anesthetic with or without steroids into the epidural space have been shown to significantly decrease both acute and chronic pain along the dermatomes subserved by nerve roots traversing this area. There are numerous pathologies that can cause pain in or originating from the thoracic spine. Radicular pain can radiate along thoracic dermatomes and thus result in pain anywhere from the chest to the lower abdomen. Pain from other structures of the thoracic spine can cause axial pain or pain that radiates along the flanks and anteriorly. The anti-inflammatory effects of steroids and analgesia from local anesthetics infused via a thoracic epidural injection provide both diagnostic and therapeutic benefit for patients experiencing these kinds of pain. Though thoracic pain and thoracic stenosis resulting in radicular pain are less commonly encountered than similar painful pathologies in the cervical and lumbar spine, thoracic pain can be just as severe and can affect breathing and daily function. Therefore, having thorough familiarity with the anatomy, technique, and potential benefits and complications related to thoracic epidural steroid injections gives a pain physician an important tool to combat what can be severe pain of the thoracic spine, chest, and abdomen.
KeywordsThoracic epidural steroid injection Chest pain Postherpetic neuralgia Thoracic radiculopathy Artery of Adamkiewicz Epidural injection Post-thoracotomy pain syndrome
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