- Joined
- Jul 7, 2013
- Messages
- 295
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- 72
There's still a LOT of ppl who do series of 3 epidurals. It's abhorrent practice when it's done indiscriminately and questionable still when done under select circumstances (large extrusion, otherwise normal L/spine).
...BUT....
The epidurals in the c/s don't have the track record of success that TFESI or LESI have in the lumbar spine. I'm finding more often I wish I'd told the patient I would schedule two CESIs a couple weeks apart (or in some pts a TFESI and CESI). So I'm seeing people go from let's say 7/10 pain with persistent radiculitis to 3-4/10 pain trace radiculitis. No facet pain elicited on exam. I never offer a second one when they come with pain in the low range like that--I just let them leave. But I often regret I didn't automate a second one to see if I could get it to 1-2/10 more routinely. I have no way to gauge an answer b/c I've never been one to do more than 1 at a time and look for a result before proceeding. Anybody have an opinion?
...BUT....
The epidurals in the c/s don't have the track record of success that TFESI or LESI have in the lumbar spine. I'm finding more often I wish I'd told the patient I would schedule two CESIs a couple weeks apart (or in some pts a TFESI and CESI). So I'm seeing people go from let's say 7/10 pain with persistent radiculitis to 3-4/10 pain trace radiculitis. No facet pain elicited on exam. I never offer a second one when they come with pain in the low range like that--I just let them leave. But I often regret I didn't automate a second one to see if I could get it to 1-2/10 more routinely. I have no way to gauge an answer b/c I've never been one to do more than 1 at a time and look for a result before proceeding. Anybody have an opinion?