Colorado Neck & Back Pain Treatments
The epidural adhesiolysis procedure is a minimally-invasive technique proven
effective for treating neck and back pain due to scar formation. After
this very safe procedure, you should experience significant pain relief
with long-term results.
What is the purpose of the epidural adhesiolysis procedure?
Scar tissue can form around nerve roots, which leads to constant, severe
pain. Adhesions form due to irritation and inflammation in the area around
these nerves. When adhesions aggravate nearby nerve roots, it leads to
intense discomfort. The epidural adhesiolysis procedure is used to remove
scar tissue in the neck or back region.
What conditions are associated with scar tissue in the epidural space?
Depending on the patient, back pain due to adhesions occurs from many causes.
Some of these include:
- Failed back surgery syndrome
- Frequent epidural steroid injections
- Lumbar stenosis
- Lumbar radiculopathy
How do I prepare for the procedure?
The pain management specialist will order and review a magnetic resonance
imaging (MRI) scan to identify is the nerves affected by scar tissue.
After a series of epidural steroid injections to treat your pain, the
doctor will determine whether or not removing the scar tissue can help.
Before your procedure is scheduled, the doctor will ask questions about
your symptoms, take a detailed medical history, and conduct a comprehensive
examination. You should tell the doctor about all medicines you take,
arrange for someone to drive you home, and wear loose-fitting clothing
to your appointment.
How is the epidural adhesiolysis procedure done?
When you arrive to your appointment, a nurse had you fill out paperwork,
instructs you to change into a gown, and places an intravenous catheter
in your arm. You are positioned face-down on the table, and a mild sedative
is given. The skin is cleaned and numbed, and a guide wire is placed into
the epidural space using real-time x-ray imaging. Once the catheter is
in the right position, medications are injected to dissolve the scar tissue
and reduce irritation and inflammation. After the procedure, the needle
catheter is removed, and a bandage is applied.
What medications are used?
During the epidural adhesiolysis procedure, medications used include a
corticosteroid (triamcinolone or dexamethasone), an anesthetic (bupivacaine
or lidocaine), hypertonic saline, omnipaque, and hyaluronidase.
What can I expect after the epidural adhesiolysis procedure?
After the epidural adhesiolysis procedure, expect to have some soreness
at the needle insertion site. You should rest for 1-2 days, and slowly
return to usual activities. The steroid begins to work after 48-72 hours,
so discomfort is relieved. The procedure is designed to dissolve scar
tissue, and research studies show it offers long-term effectiveness of
epidural lysis of adhesions.
Does epidural adhesiolysis work?
According to the American Society of Interventional Pain Physicians, the
epidural adhesiolysis procedure works well for long-term pain control
in radiculopathy and refractory pain. In a large study, 100% of patients
treated experienced long term pain relief. The patients stated that they
decreased use of pain medicines and enjoyed improved functional status
and overall mental health. In another study involving 234 patients with
failed back surgery syndrome, mechanical removal of adhesions improved
pain scores and functional status in all patients at the 48-month follow-up.