What is an epiduroplasty?
An epiduroplasty or epiduroscopy consists mainly of inserting a special catheter into the spinal column while monitoring its progress in real time thanks to X-ray vision.
It is a relatively new technique that is quite effective in treating chronic low back pain without the need for anesthesia. It is a technique that makes it possible to treat the pain and at the same time determine what is causing it, so that it can be diagnosed and treated at the same time.
Thanks to the epiduroscope -with a structure similar to that of the endoscope, although smaller- it is possible to see the inside of the epidural space thanks to the microcamera at one of its ends. The duration of epiduroplasty lasts about one hour and is performed under local anesthesia.
Why is epiduroplasty performed?
Epiduroplasty is performed in order to observe the epidural space, i.e. the inner part of the spine in order to diagnose and initiate treatment of painful spinal cord pathologies and syndromes.
Epiduroplasty is usually indicated for the following:
- Patient with severe sciatica with no surgical indication and unresponsive to treatment.
- Selective application of medications
- Adhesions and fibrosis following surgery
- Neuromodulation
- Biopsies when performing minimally invasive techniques.
This is a technique for diagnosing spinal and meningeal pathologies and lesions in which a biopsy can be performed at the same time as the examination.
This technique is not recommended in patients with respiratory insufficiency or with alterations at the puncture site, such as infections, tattoos or anatomical defects. In the case of coagulation alterations, it cannot be performed either.
Epiduroplasty is useful to treat severe sciatica, among other diseases and pathologies.
What does epiduroplasty consist of?
Designed to diagnose and treat painful pathologies of the spinal cord, epiduroplasty uses a flexible endoscope equipped with a camera at one end.
Anatomical structures such as the dura mater, epidural veins, nerve fibers or connective tissue can be easily identified.
The treatment is performed in the prone position, with intravenous sedation and local anesthesia. The epiduroscope is introduced progressively with the aid of X-ray imaging until the desired level is reached. Once in place, the desired area is acted upon and then an anesthetic is administered around the affected nerves in the area.
Preparation for epiduroplasty
An epiduroplasty is an outpatient procedure that is performed in the operating room but does not require the patient to be admitted, but will be discharged the same day of undergoing treatment, after having spent a few hours under observation.
In order to undergo the treatment, the patient should go to the health center fasting for at least six hours.
Care after epiduroplasty
The patient will be discharged the same day the treatment was performed, after having spent a few hours in the recovery room, where he/she will remain for a while under observation.
Since local anesthetics are used, the patient may feel numbness in the legs for a few hours, although this is a completely normal symptom.
The patient will not be discharged until he/she can fully control his/her legs.
Alternatives to epiduoplasty
An alternative treatment to epiduroplasty without being a surgical method would be joint infiltrations and radiofrequency denervation or rhizolysis, consisting of the use of radio waves to improve long-term pain and problems caused by low back pain, cervicalgia or dorsalgia.