ESI is commonly used for relief of upper and lower back pain secondary to spinal stenosis, disc herniation with or without radicular pain, and refractory back pain of unknown etiology. ESI may help delay or prevent surgical treatment because many patients receive pain relief that allows them to endure an acute exacerbation of pain. ESI when combined with physical therapy and antiin-flammatory medications can provide satisfactory pain relief in patients who are not surgical candidates.

Epidural Space Mri
Fig. 2. Sagittal MRI of the epidural space. The epidural space is triangular in shape viewed in this sagittal plane, and most prominent in the sublaminar region.

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