Lumbar Transforaminal Epidural Steroid Injection
A lumbar transforaminal epidural steroid injection (TFESI) delivers anti-inflammatory steroid medication directly through the foramen — the opening through which the nerve root exits the spinal canal — placing medication precisely at the site of nerve root compression or inflammation.
Transforaminal vs. Interlaminar Approach
Unlike the traditional interlaminar epidural approach (which accesses the epidural space from the back), the transforaminal approach enters from the side, targeting a specific nerve root level. This allows more precise delivery of medication to the exact nerve root causing a patient's symptoms.
When your MRI shows a disc herniation or foraminal stenosis at a specific level (such as L4-L5 or L5-S1) causing symptoms corresponding to that nerve root's distribution, the transforaminal approach allows targeted treatment of that specific root.
Conditions Treated
- Lumbar disc herniation with radiculopathy (sciatica)
- Foraminal stenosis at a specific level
- Post-surgical radicular pain at a known nerve root level
- Acute disc herniation with severe radicular symptoms
The Procedure
Under fluoroscopic guidance with contrast confirmation, Dr. Rubin advances a needle through the foramen to the anterior epidural space — the area directly adjacent to the compressed nerve root. A small volume of steroid and anesthetic is then injected. The precision of this approach maximizes the anti-inflammatory effect at the exact site of pathology.
The procedure takes approximately 20–30 minutes as an outpatient.
Results
Transforaminal ESIs often produce faster and more targeted relief than interlaminar injections for single-level disc herniations. Many patients experience significant leg pain reduction within 1–2 weeks.
Schedule a Consultation
Call 516-492-3100 to discuss whether a transforaminal epidural injection is the right approach for your back and leg pain.