Spine · Pain management

Lumbar Epidural Steroid Injection (LESI)

See what the procedure is, how the room may be arranged, who may be present, and what must be confirmed for the case.

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Free orientation

LESI: the essentials

This page builds familiarity without directing care. The active order, patient-specific plan, responsible clinician, and local policy always take priority.

What it is

An image-guided injection, not open surgery

A clinician delivers medication into the lumbar epidural region near irritated spinal nerves. Live X-ray imaging is commonly used to view the area during the procedure.

Why it may be considered

For certain pain linked to irritated lumbar nerves

Symptoms may travel from the lower back into the hip, leg, or foot and can include pain, tingling, numbness, or weakness. LESI is not a general explanation for every kind of low-back pain.

Approach names you may hear

Interlaminar The path approaches the epidural space between adjacent parts of the vertebrae.
Transforaminal The path uses the opening where a spinal nerve exits, closer to a selected nerve root.
Caudal The path enters near the tailbone and approaches the epidural space from below.
Terms and case details worth confirming
LumbarThe lower-back portion of the spine.
Epidural spaceThe area outside the protective covering around the spinal cord and nerve roots.
SteroidAn anti-inflammatory corticosteroid medication. The exact medication comes from the active order.
The name does not confirmApproach, spinal level, side, medication, sedation plan, or facility workflow.
Visual orientation

What the room may look like

A conceptual view of common room elements—not a fixed staffing model, workflow, or depiction of technique.

AI-generated conceptual LESI room showing a fully draped patient face-down on a procedure table, an X-ray technologist positioning a side-mounted C-arm, a clinician and surgical technologist beside the lumbar area, and a nurse near the patient's head and monitor
Conceptual room orientation for an image-guided lumbar injection Actual equipment, positioning, staffing, and room layout vary.

AI-generated educational illustration developed from general clinical-room references. It is provided for visual orientation and does not establish a required setup or technique.

Before, during, and after: the high-level flow
Before

Verify and position

The team confirms the patient and planned procedure, reviews relevant information, and positions the patient—often face-down. Monitoring and sedation vary.

During

Image and maintain the field

The lower back is prepared as a sterile working area. Fluoroscopy—live X-ray—is commonly used to view the anatomy during the procedure.

After

Observe and give instructions

The patient is commonly observed for a period and receives instructions specific to the procedure, medications, and facility plan.

Room, imaging, positioning, and team context
WhereOften a hospital outpatient department, pain clinic, ambulatory procedure center, or physician office equipped for image-guided procedures.
ImagingA mobile or fixed fluoroscopy system can provide live X-ray images of the lumbar spine.
PositionFace-down positioning is common, with supports used for comfort and access. Patient needs may change this.
Who may be presentA procedural clinician and clinical support staff are common. Imaging, monitoring, and sedation support depend on the setting.
The VSEEE pattern

What is common, what may vary, and what to confirm

Common

  • A sterile working area
  • Image-guidance equipment
  • Patient and procedure verification

May vary

  • Approach, spinal level, and side
  • Medication and monitoring plan
  • Sedation, staffing, and recovery

Confirm

  • Patient, procedure, level, and side
  • Active order and patient-specific plan
  • Responsible clinician and local policy
Sources and review

What supports this orientation

Sources checked 8 August 2026. Independent clinical review is still pending.

Medication is delivered into the lumbar epidural region around spinal nerves in the lower back.
The procedure may be considered for certain patterns of lumbar radicular pain extending into the hip, leg, or foot.
Fluoroscopy is commonly used for live X-ray visualization during image-guided epidural injections.
Interlaminar, transforaminal, and caudal describe different access approaches.
RadiologyInfo.org · Epidural Injections ACR / RSNA patient reference · Last reviewed 11 March 2024 Cleveland Clinic · Lumbar Epidural Steroid Injection Medically reviewed overview · Last updated 19 November 2021 U.S. FDA · Epidural Corticosteroid Safety Communication Regulatory safety context · Issued 23 April 2014

Content status

Content version
0.7
Source check
Completed 8 August 2026
Clinical review
Pending — this page does not yet claim independent clinical review
Latest change
Reorganized the free orientation, added visual provenance, corrected terminology, and clarified review status.

VSEEE guides and orients; it does not direct clinical care or replace active orders, patient-specific plans, professional judgment, facility policy, manufacturer instructions, or confirmation with the responsible clinician.

Free orientation complete Everything above remains available without an account.