Epidural Lysis of Adhesions

Epidural Lysis of Adhesions

What is Epidural Lysis of Adhesions?

This is a more aggressive approach to a typical Epidural Steroid Injection. An epidural lysis of adhesions is a procedure that was developed to help decrease chronic low back pain due to adhesions and scar tissue formation. This is a catheter injected procedure and is inserted into the epidural space in order to access the area of adhesions.

Epidural adhesions are most commonly observed following surgical intervention of the spine, leakage of disc material into the epidural space following annular tear or an inflammatory response. Scar tissue may restrict movement of nerves causing inflammation, therefore, creating pain.

How is the procedure performed?

The physician will inject local anesthetic to numb up the area prior to placing the catheter through the skin. Once the local anesthetic has set in, the epidural needle will then be introduced through the skin and into the sacral hiatus. Mild sedation will also be administered to ease any anxiety, however, general anesthesia is not an option since your participation in the procedure is critical to reduce the risk of any complication. Following placement of the epidural needle, the catheter is advanced into the injection site. The movement of the catheter is continuously monitored with the C-arm (X-ray) to assure safe and effective positioning. Contrast material (a metallic fluid that shows up on X-ray) will then be injected into the epidural space to outline the epidural space, this is called and epidurogram. Other fluids will then be injected to relieve pain, dissipate scar tissue, and reduce inflammation.