Definition
Epidural infiltration (infiltrations close to the spinal cord) is a conservative injection therapy used to treat orthopedic spinal disorders that lead to irritation-inflammation of the nerve structures located in the spinal canal (spinal cord, nerve roots). Inflammation of the spinal cord and nerve roots always occurs when the space for these nerve structures in the spinal canal becomes too small. Such nerve inflammation is a non-bacterial inflammation, i.e. bacteria and pus do not play a role.
The sole cause is pressure damage to the nerves. As a result of the inflammation process, the spinal cord and nerve roots swell, further reducing the remaining reserve space for these nerve structures. A vicious circle develops: Pressure damage -> inflammatory swelling -> further pressure damage.
Classical clinical pictures for therapy with infiltrations near the spinal cord are herniated disc protrusion and narrowing of the spinal canal (spinal canal stenosis). In a herniated disc, disc material from the nucleus of the disc emerges from the back of the disc into the spinal canal and presses the spinal cord, and more often the nerve roots. It is usually a sudden event with severe back-leg pain (lumboischialgia; lumbar spine) or neck and arm pain (cervicobrachialgia; cervical spine), depending on where the herniated disc is located.
In exceptional cases, a herniated disc can also trigger such strong pain symptoms that a therapy with epidural infiltration appears to be appropriate. In spinal canal stenosis, signs of wear and tear of the spine are the cause of a usually slowly increasing spinal canal narrowing. The symptoms usually develop insidiously.
The lumbar spine is more frequently affected. The spread of pain often affects both legs. The complaints are very often a lack of strength in the legs and increasing insecurity when walking.
In spinal canal stenosis, signs of wear and tear of the spine are the cause of a usually slowly increasing narrowing of the spinal canal. The symptoms usually develop insidiously. The lumbar spine is more frequently affected. The spread of pain often affects both legs. The complaints are very often a lack of strength in the legs and increasing insecurity when walking.