The benefits from the first shot only lasted 2 weeks. The second and third set of injections lasted about 90 days. In November, I was ready to have surgery. My EMG and nerve conduction tests proved that the nerves were "sleeping" before I was. After another MRI, the neurosurgeon said I was a candidate for surgery but I was not able to get the endoscopic type surgery that is less invasive. I would have an incision about 6-8" long. Along with removing the herniation, they would have to increase the size of the hole where the nerve roots were going through.
Following local anesthesia, the cervical vertebrae is identified by using x-ray. X-ray is used both in anterior posterior view and lateral view to identify the space of the epidural where the medication will be injected. Most often C5-C6, C6-C7, and C7-T1 space is selected for epidural steroid injection. After local anesthesia, the epidural needle under the guidance of the x-ray is inserted into the epidural space. After the needle is inserted into the epidural space, dye is injected. After satisfactory spread of the dye in cephalic and caudal directions as well as lateral direction, medication are injected in to the epidural space. Medication injected is corticosteroid such as Depo-Medrol or Kenalog. The amount injected is between 40 to 80 mg. In some center solid cortex as the corticosteroid also is injected. The corticosteroid may be mixed with normal saline for dilution. Local anesthesia is rarely injected into the cervical steroid space because there may be few rare cases where the needle may be in the subdural space and local anesthesia may cause total spinal block. After the injection, patient is observed in the recording room before discharge and patient is observed for the pain control.