CEACCP: Epidural Steroids (Read) for Medical Doctors

Permission has been granted by Elsevier on behalf of the British Journal of Anaesthesia to link directly to articles and MCQs from BJA Education on e-Learning Anaesthesia.

Key points

• Epidural steroids are used in the treatment of radicular and other spinal pain of an inflammatory origin emanating from the cervical, thoracic, and lumbar spine.
• The use of epidural administration of steroids is to produce higher local concentrations at an inflamed nerve root and other areas of inflammation in the spinal canal area.
• The three most common methods are via the caudal route, the interlaminar approach, and the transforaminal approach.
• Different steroid preparations have dissimilar physicochemical properties and these may affect outcomes and side-effects.
• There is an ongoing debate with regard to the use of particulate and non-particulate steroids for transforaminal epidural injections for chronic pain patients.