Epidural Nerveblock (TF Injections)
At The Brain and Spine Centre, we specialize in the diagnosis and surgical treatment of neurological and spinal disorders. Dr. Muhammad Aqeel Natt, a leading neurosurgeon in Lahore, provides advanced, safe, and compassionate care for patients.
Epidural Nerveblock (TF Injections)
Epidural nerve blocks, specifically transforaminal (TF) injections, deliver corticosteroid and anesthetic directly to inflamed nerve roots exiting the spinal foramina to reduce radicular pain from disc herniation, stenosis, or spondylolisthesis. At The Brain and Spine Centre, Dr. Muhammad Aqeel Natt performs fluoroscopy-guided TF injections at Farooq Hospital, West Wood Branch, Lahore, as targeted therapy for spinal pain before considering surgery.
Our goal is simple: reduce nerve root inflammation, provide diagnostic confirmation of pain generator, and delay or avoid surgery with 50-80% short-term relief.
What Are TF Epidural Nerve Blocks?
Transforaminal epidural steroid injections target the dorsal root ganglion or nerve sleeve through the neural foramen using fluoroscopic guidance, delivering steroid precisely to the affected nerve root while minimizing systemic effects. Unlike interlaminar epidurals, TF approach allows ventral epidural spread for optimal radiculopathy relief.
Symptoms and Indications
Ideal for radicular pain unresponsive to oral meds/PT.
Common indications:
Sciatica from L4-S1 disc herniation.
Lumbar stenosis with leg pain (neurogenic claudication).
Cervical radiculopathy (C5-C7).
Spondylolisthesis, post-laminectomy syndrome.
Diagnostic: confirms surgical target if >80% relief.
Diagnosis and Evaluation
MRI: confirms foraminal stenosis, herniation compressing specific root.
Clinical: dermatomal pain, positive straight-leg/Spurling, weakness.
The Procedure
Outpatient, 15-30 minutes under local anesthesia/conscious sedation.
Steps:
Prone positioning; fluoroscopy confirms level (Scottie dog view lumbar).
Skin antiseptic; local anesthetic numbs entry.
22-25G needle advanced to “safe triangle” (SAP, IAP, PLL); contrast confirms foraminal spread without vascular uptake.
Steroid (dexamethasone/ triamcinolone 4-10 mg) + anesthetic (lidocaine/ bupivacaine) injected.
Monitor 15-30 min post-injection for rare complications.
Recovery & Aftercare
Immediate relief possible; peak effect 3-7 days.
Drive home same day; avoid heavy lifting 24 hours.
Up to 3 levels/year; repeat 2-3x if effective.
PT during steroid window maximizes outcomes.
Results You Can Expect
50-80% achieve >50% pain relief at 1-3 months.
Leg pain responds better than back pain.
80% relief predicts surgical success.
Duration: 3-12 months; 20-30% long-term benefit.
Why Choose The Brain and Spine Centre
Fluoroscopy-guided precision minimizing vascular injection risk. Performed by neurosurgeon familiar with surgical anatomy. Integrated with spine program: injections bridge conservative to surgical care.
Cost of TF Epidural Injections
Per-level outpatient procedure; series of 3 costs less than surgery. Estimates provided pre-procedure.
