Spinal injections
Intraspinal injections are intended to provide relief by injection of an anti-inflammatory agent (e.g. steroid); and/or anesthetic into the spine or space around the spinal nerves and joints. Intraspinal injections include epidural steroid injections, facet joint injections, medial branch block, sacroiliac joint injections and intradiscal steroid injections.
Spinal injections were first reviewed by the HTA program in 2011.
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In 2015, the HCA director selected spinal injections for rereview based on newly available published evidence that could change the original determination.
Status: Decision completed
Why are spinal injections being reviewed?
In 2011, HTA conducted an initial evidence review of spinal injections and the Health Technology Clinical Committee (HTCC) determined therapeutic medial branch nerve block injections, intradiscal injections and facet injections are not a covered benefit. Therapeutic lumbar epidural injections, cervical-thoracic epidural injections, and sacroiliac joint injections are a covered benefit for the treatment of chronic pain following certain conditions. In 2015, new literature was identified addressing the use of spinal injections, including new safety concerns voiced by the FDA.
Primary criteria ranking
- Safety = Medium
- Efficacy = High
- Cost = Medium
Documentation
| Type | Materials |
|---|---|
| Assessment (2016) | |
| Assessment (2011) |
Assessment timeline
- Draft key questions published: September 1, 2015
- Public comment period: September 1 to 15, 2015
- Final key questions published: October 13, 2015
- Draft report published: December 16, 2015
- Public comment period: December 16 to January 14, 2016
- Final report published: February 12, 2016
- HTCC public meeting: March 18, 2016