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Multiple ESIs done at multiple levels?

Lala329LLala329 Posts: 283
edited 06/11/2012 - 8:42 AM in Spinal Injections

I was wondering if anyone has had ESI's done fairly close together in time at multiple levels?

To keep things short: I have tarlov cysts and we are starting to think they may be my remaining source of pain. I have them at T12, L5, and all the sacral levels. I had an ESI at L1/L2 to see if it would affect the localized pain I was having around T12 and it did help, but had no effect on the pain lower down in my lumbar spine. My doctor is thinking that if the tarlov cysts are the pain source, then repeating the epidural but at L5/S1 to try to get closer to the lower cysts may be a good option.

I'm just confused though because it seems like flooding the epidural space with cortisone regardless of where the needle is placed would spread the cortisone throughout the epidural space including the lower and higher levels. Is that incorrect? I know it's common for people to have multiple herniated discs, so is it normal to do the epidural at several levels to make sure all the discs and nerve roots get good steroid coverage?



  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,745
    In most cases, you can only get 3 to 4 ESI's per year depending on the amount the Dr. uses.
    Good luck, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • Thanks for the response Jim. I am a little concerned about using up 2 of my 3 so close together in time. I'll have to make sure I ask my doctor that if doing it in 2 separate locations has any effect on the number I'm allowed to have.

    I stumbled across the answer to my question, and thought I'd post in case anyone else was curious. With ESI's the cortisone typical spreads up and down 1-2 levels, so wherever the needle is placed you can expect it to also hit 1-2 levels above and/or below.

    Thanks guys :)
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  • I had an ESI done into T8/9 in February. Another one into L5/S1 in March. And then they made the dosage smaller for a quadrouple ESI into T10/11 L1/2, L2/3, L3/4. The quadrouple ESI was done on the same day with no sedation. I wouldn't recommend doing that big of a procedure without sedation. Having that much cortisone in a local area will not have negative effects on your back. Regardless of location you can only have three ESI's per six month period. None of the ESI's that I got have helped with my back and leg pain so i'm kinda stuck because im 18 and my doctor isn't recommending surgery.
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