Adhesion epidurolysis is an intervention aimed at reducing pain caused by nerve compression.
Also known as epidural adhesiolysis, epidural neurolysis, epidural neuroplasty or Racz procedure, this technique consists of destroying the fibrosis tissue formed in the epidural space of the spinal column after disc herniation surgery (scarring).
When is it indicated?
The fibrosis formed in the epidural space causes radicular pain as a consequence of repeated trauma, which occurs every time the nerve roots are stretched and compressed against these scars.
By means of this technique it is possible to apply drugs to the exact site of the lesion and it is also possible to apply radiofrequency to the affected spinal ganglia.
In this sense, this technique is indicated in patients who have had a poor response to conservative medical treatment and epidural infiltration on several occasions. It is also indicated in patients with low back pain after undergoing multiple back surgeries.
How is the procedure performed?
The procedure is always performed under radioscopic control, following radioprotection recommendations.
First, the patient is placed face down and monitored. Then the puncture site is sterilized and infiltration is performed with local anesthesia at the point of entry. Radioscopic vision is used to check that the needle position is correct.
The catheter is then inserted through the needle and once the target is reached, contrast is administered to detect which part of the epidural space has the greatest degree of fibrosis and which roots are most affected. After that, the rest of the medications are administered.
What is the recovery period like?
After the operation, and once the bladder and motor function has been checked, the patient is discharged. It is recommended that the operated area is kept dry for 48 hours. After this period, the patient can take showers, but cannot bathe until at least 10 days after the operation.
On the other hand, physical exercises are recommended to improve muscle tone and promote stretching of the spine.
Risks of adhesion epidurolysis
If there is a persistent sensory or motor deficit, an MRI should be performed to rule out serious complications, such as spinal cord compression or hematoma, among others.