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Regarding the ESI, find out what they are going to be using. I know they have been using Depo-Medrol for this procedure. I went through ESI for pain management pre and post op for L5/S1 spondylolisis/spondylolisthesis.
Some studies have indicated that depo-medrol may be one of the causes of arachnoiditis. While they believe only between 1 & 5% of those who recieve depo-medrol develop this it is still to many when there are alternatives to depo. Why do they believe this?
Depo-medrol contains benzyl alcohol which is potentially toxic when administered locally to neural tissue.
Celestone Soluspan & Kenalog have both been used in studies and have been shown to be effective in the relief of pain when applied as an ESI.
The method of delivery is also something you should address with the docs. Blind injections are not the way to go if it can be avoided. The best way to administer the dose is under fluoroscopy to ensure proper placement of the needle.
I did not know any of this prior to my pain management and I fell into the 1-5% of those who develop arachnoiditis. Wether it was from the ESI, Myleogram or the surgery itself is anyones guess. However, if anything I learned from my ordeal can help others then I am all to willing to share.
I hope your pain management goes well for you.
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