After back surgery or a serious injury affecting the spine, adhesions (bands of fibrous scar tissue) naturally develop in the epidural space as part of the normal healing process. The epidural space is the area between the spinal cord and the vertebral bones that surround it. When in excess, this scar tissue may compress the nerves and restrict their movement, causing inflammation and pain.
Lysis of adhesions is an outpatient procedure performed to decrease the amount of scar tissue (or remove it completely), which releases tension on the nerves and thus relieves pain. This is a procedure Dr. Zaki Anwar offers to his patients at Pain Management Institute. It involves the use of a specialized catheter to inject various medications into the epidural space to dissolve or physically break-down the epidural adhesions.
The exact combination of drugs can vary, but most often used is a steroid to reduce inflammation around the nerves, a chemical enzyme (hyaluronidase) to dissolve the adhesions, and a local anesthetic. Lysis of adhesions is a safe, effective and proven method for pain relief.
Patients who have developed scarring in the spinal canal due to other medical conditions may also benefit from this procedure. Patients usually undergo an epidural injection (the donut shaped space that surrounds the spinal canal) that reveals an obstruction to the flow of dye seen under x-ray. If the obstruction (blockage) of dye corresponds to the specific nerve the pain is coming from, then they may be a candidate for this procedure. In addition to treating excessive scarring, this procedure can be used to treat a range of other back and spine conditions, including:
- Herniated or prolapsed intervertebral discs (especially when not surgically correctable)
- Metastatic carcinoma of the spine (leading to compression fracture)
- Degenerative spondylosis (affecting multiple levels of the spine)
- Spinal (back) stenosis (a narrowing of the open spaces within the spine)
- Cervical (neck) stenosis
- Post-laminectomy syndrome (failed back surgery syndrome).
- Degenerative arthritis of the spine
- Occipital neuralgia
Epidural lysis procedure is not a “first line” treatment meaning, the patients who undergo this therapy have tried more conservative treatment options such as medications and epidural steroid injections, surgery, which have failed to relieve their pain.
After the procedure, patients are observed for a short amount of time in the recovery area before being discharged to go home. Patients may experience some mild numbness or heaviness in their legs following the procedure, but this normally lasts no more than 24 hour. Normal routines can generally be resumed the next day.
The vast majorities that have opted for this option have achieved remarkable improvement in the severity of pain and mobility. Relief is not immediate though; it can take several days and up to two weeks before the injection takes effect. The level of relief varies from patient to patient, but most experience pain relief lasting for 2 to 3 months. Physical therapy can help sustain improvement after the procedure.
If you have persistent, nagging back or neck pain following surgery, don’t suffer any longer. Please call Pain Management Institute at 815-464-7212 to schedule your evaluation with Dr. Zaki. He is very experienced in interventional treatments and a world renowned Pain Medicine Physician who has been practicing ways to cure pain leading to serious problems for the past several years After determining the cause of your pain, he may use a variety of treatments to provide you with pain relief.