A cervical epidural steroid injection, or CESI, is a procedure used to treat pain coming from a compressed nerve or nerves in the neck or upper back. It involves injecting corticosteroids—a type of drug that reduces inflammation and helps relieve pain—into the epidural space, which is a space just outside the covering of the spinal cord.
Cervical Epidural Steroid Injection
How is CESI done?
You will be lying on your abdomen for the procedure, and your doctor will put a topical anesthetic on your skin, to keep you comfortable. You may also be given medication to help you relax.
Using fluoroscopy, a type of live X-ray, to guide the procedure, your doctor will insert a small needle in the epidural space in your neck. The needle will be used to inject contrast dye so your doctor can be sure the medication will reach the target area. Then your doctor will inject the corticosteroids as well as an anesthetic medication, such as Lidocaine.
What happens after the procedure?
You will be able to go home the same day, but you'll need someone to drive you. You shouldn't overexert yourself the first day. You may feel some relief from your pain immediately, due to the local anesthetic, but your pain may come back when that wears off in a few hours. You should start to feel more lasting pain relief within a week, after the cortisone medication begins to take effect.
What are the risks?
CESI is quite safe, but as with any procedure, there is always a possibility something may go wrong. Potential risks include allergic reaction to one of the medications and a small risk of infection. Other rare risks include the possibility of the needle touching the spinal cord or nerve root, causing a neurological injury, or the possibility of the needle going in too deeply, causing a hole in the tissue surrounding the spinal cord, which can cause headaches until it heals up.
Is CESI right for you?
CESI is used for conditions that irritate the nerves in the cervical spine, such as herniated disk, cervical spondylosis, and cervical spinal stenosis. If you have pain related to nerve compression in the cervical spine and haven't been able to get relief from other treatments, you may be a candidate for CESI.
