Disk Slippage (Spondylolisthesis)

What is disc slippage?

A disc slippage (Spondylolisthesis) is a displacement of one vertebra in relation to the vertebra below. This is a common condition and an incidental finding in x-rays. It usually does not cause any pain.

In some people however, the slippage can put mechanical pressure on the spinal cord or the nerve roots, thus causing pain in the back, legs and inability to walk long distances. Epidural injections are used to reduce the pain in individuals with this condition, in order to delay or avoid surgery, which is the treatment of choice if other treatments have failed..

What is the epidural space?

The roots of the spinal nerves exit your spine from small nerve holes and travel into your arms or legs. These nerves allow you to move your arms and legs. The covering over the nerve roots in the spine is called the dura. The space surrounding this dura is the epidural space.

What is an epidural injection?

An epidural injection is the injection of medicine between the backbones into the epidural space to reduce inflammation and swelling, which can then reduce the pain signals.

This procedure is used only in people with spinal stenosis (narrowing of the central spinal canal) or slippage disc (spondylolisthesis). This procedure should not be used in individuals with a nerve impingement.

It is important to know the epidural injections should not be done blindly, without fluoroscopic guidance. Studies have shown that done blindly, the epidural injection is missed in at least 25% of patients, even in the hands of experienced physicians. Done blindly, the injection could be more painful for you.

What will happen to me during the procedure?

After the doctor has administered an intravenous pain reliever, you will lie on your stomach. The skin over your back will be well cleaned. Next, the physician will numb a small area of skin, which stings for a few seconds.

Next, the physician will use fluoroscopic guidance to direct a needle into the epidural space. Then the physician will inject contrast dye to confirm that the medicine flows in the epidural space. Lastly, a combination of numbing medicine and time- release anti-inflammatory cortisone will be injected.

What will happen to me after the procedure?

You will rest in the recovery area for 30 minutes before going home. Your heart rate and blood pressure will be monitored. You will be given instructions regarding your pain, activity, driving, etc.