Epidural lysis of adhesions is a percutaneous spinal procedure for pain relief. Epidural lysis is a minimally invasive spine surgery which involves the dissolution of epidural scar tissue by mechanical means to facilitate the spread of analgesics in an effort to alleviate pain. Epidural lysis commonly used to treat chronic pain resulting from failed back surgery syndrome where scar tissue has formed around the nerves and causes pain. Evidence suggests that the epidural lysis procedure may also be effective in treating spinal stenosis and radicular pain caused by a herniated disc.
Epidural lysis is also known as percutaneous adhesiolysis or RACZ procedure.
Epidural lysis procedure:
Your physician will review your MRI before performing the epidural lysis procedure in order to check or identify which nerves are likely affected and are responsible for your pain.
At first, a series of epidural steroid injections are often performed to localize and treat your pain. The response to the epidural steroid injections will be limited if the cause of your pain is scar tissue.
Once scar tissue is thought to be the cause of you pain you will be schedule for the epidural lysis procedure.
- The epidural lysis procedure is performed by injecting a local anesthetic with a small needle into the skin above your buttock.
- After the area has been numbed, then using a larger needle a catheter/guide wire is placed into the epidural space by using x-ray guidance for proper placement.
- Once the catheter is in the proper location that is where the scar tissue is affecting the nerve root, multiple medications are injected into the space in contemplation of dissolving the scar tissue and reduce the inflammation and irritation on the nerve. Medications which are using in epidural lysis procedure include omnipaque, hypertonic saline, hyaluronidase, local anesthetics, and steroids.
- The epidural lysis procedure has been performed generally over a two-day period with another injection of materials through the catheter the following day to ensure lysis of scar tissue has been achieved.
The procedure typically finished in less than an hour. Immediately after epidural lysis procedure, you may fell that your legs are heavy and may have some sensory changes, but these are temporary. Local numbing anesthetic wears off in a few hours and the inflammation-reducing steroid generally starts working at about forty-eight hours.
Epidural lysis procedure benefits:
- The purpose of the epidural lysis procedure is to minimize the deleterious effects of epidural scarring, which can physically prevent direct application of drugs to nerves and other tissues in the treatment of chronic back pain.
- To dissolve scar tissue therefore reducing pressure on irritated nerves.
Zaki Anwar MD is an Anesthesiologist and Interventional Pain Management Specialist .Zaki Anwar has vast expertise for the diagnosis and treatment of back pain, headaches, migraines, neck pain, sciatica pain and various pain conditions.
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