Understanding Pain
Diagnosis & Understanding
4. Neck Pain
1:55
6. Painful Diabetic Neuropathy
1:46
8. Foot Pain
1:50
9. Ankle and Foot Pain
1:46
10. Cancer Pain
1:34
Non-Surgical Treatment Options
2. Bracing
1:30
3. Acupuncture
2:13
4. Physical Therapy
1:35
5. Cognitive Behavioral Therapy
2:08
Minimally Invasive & Surgical Treatments
2. Regenerative Medicine
2:06
5. Caudal Epidural
1:33
10. Sacroiliac Joint Fusion
1:39
11. Kyphoplasty and Vertebroplasty
2:05
12. Basivertebral Nerve Ablation
1:36
13. MILD Procedure
2:04
14. Spinal Decompression Surgeries
1:41
15. Artificial Disc Replacement
1:52
Neck or Cervical Pain
Non-Surgical Treatment Options
2. Bracing
1:30
Minimally Invasive & Surgical Treatments
2. Caudal Epidural
1:33
5. Facet Joint Injection
1:44
10. Interventional Pain Procedures
1:58
13. Artificial Disc Replacement
1:52
Alternative & Emerging Therapies
1. Regenerative Medicine
2:06
2. PRP Injection
1:42
4. MFAT
2:04
5. Shockwave Therapy (MSK)
2:03
6. Laser Therapy
2:05
7. Ozone Therapy
1:37
Robert Moghim MD
Anchor Healthcare
Epidural Adhesiolysis (Racz Lysis of Adhesions)
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Epidural adhesiolysis, also called the Racz procedure, is designed to help relieve chronic pain by breaking down scar tissue (adhesions) that may cause nerve pain in the spine. Scar tissue can develop after back surgery or from conditions like spinal stenosis, and this procedure aims to free nerves stuck by these adhesions, which can reduce pain and increase mobility. During the procedure, a flexible tube, or catheter, is gently threaded into the area with scar tissue under imaging guidance, often using X-ray (fluoroscopy). A combination of saline solution, an enzyme, and sometimes steroids is used to dissolve and break down the scar tissue. This helps to relieve inflammation and pain.
This procedure can help reduce symptoms like:
1. Lingering pain after back surgeries. 2. Sciatica or pain that travels down the legs. 3. Pain related to compressed nerves.
For some people, this treatment can provide significant relief when other methods like physical therapy, or more basic steroid injections, haven't worked well. Alternatives to consider include physical therapy for chronic pain management, spinal cord stimulation for persistent symptoms, or, in more severe cases, surgical solutions like spinal decompression.
There are minimal risks involved, but they do include possible infection, minor bleeding, or very rare instances of nerve damage. Patients usually need to stop taking certain blood thinners before the procedure to reduce bleeding risks. The process involves a brief period of sedation and is minimally invasive, allowing for a recovery period that typically involves just a short observation time. Most patients notice improvement in their symptoms within a few days, and this improvement can last for a considerable time, sometimes up to a year, enhancing quality of life and reducing the need for pain medications.
FAQs
What are the risks associated with epidural adhesiolysis?
Although the risks are minimal, potential complications may include infection, minor bleeding, or in rare cases, nerve damage. It's essential for patients to stop taking certain blood thinners before the procedure to mitigate bleeding risks.
What is epidural adhesiolysis and how does it work?
Epidural adhesiolysis, also known as the Racz procedure, is a minimally invasive treatment aimed at relieving chronic pain by breaking down scar tissue (adhesions) in the epidural space. Scar tissue can form after surgeries or due to conditions like spinal stenosis, leading to nerve compression and pain. A catheter is placed under imaging guidance, and a solution containing saline, an enzyme, and sometimes steroids is injected to dissolve these adhesions, helping to reduce inflammation and pain.
What is the typical recovery process after undergoing the Racz procedure?
The procedure is minimally invasive, requiring only a brief period of sedation and a short observation time post-procedure. Patients generally notice symptom improvement within a few days, and this relief can last for a considerable time, potentially up to a year, enhancing their quality of life and reducing reliance on pain medications.
What symptoms can be improved with epidural adhesiolysis?
This procedure is particularly effective in addressing lingering pain after back surgeries, sciatica or pain that travels down the legs, and pain associated with compressed nerves. Patients who have not found relief through other treatments, like physical therapy or basic steroid injections, might find significant improvement with epidural adhesiolysis.
Who might be a candidate for epidural adhesiolysis?
Candidates for epidural adhesiolysis typically include individuals experiencing chronic pain related to scar tissue in the spine, particularly if they haven't found relief through conventional treatments like physiotherapy, basic steroid injections, or more conservative pain management approaches.