What is Epidural Lysis of Adhesions?

The Epidural Lysis of Adhesions, also called Racz procedure, is performed to remove excessive scarring in the epidural space. The epidural space is a thin area between the inside of the spine column and the protective layers around the spinal cord. The epidural space contains fat tissue for padding as well as blood vessels and nerve roots. The epidural space runs the entire length of the spine. Scar tissue or adhesions are not in themselves painful, but they may restrict the natural movement of nerves causing tension, compression, inflammation and pain. Patients who have had previous spinal surgery or have disc damage that is inoperable resulting in scarring or adhesions, may benefit from this procedure.

Procedure Details

The patient will be given conscious sedation through an IV (intravenous needle) inserted in their arm/hand on his/her admission to the facility where the procedure will be performed. The patient will then be escorted to the surgical suite with the nurse and asked to lay on their stomach for the procedure. The physician will perform the procedure with a special X-ray machine, called the fluoroscope, to accurately visualize the anatomy. Contrast dye will be injected to see the restrictive location or scarring area in the patient’s epidural space, which may be causing the pain. A Racz catheter will be guided with X-ray to the scarred area. A special medication called hyaluronidase is then injected, and along with the mechanical forces of the Racz catheter,the scarring will be broken up. Finally, a mixture of steroids and local anesthetics will be injected to decreased the inflammation and provide pain relief after the removal of adhesions. It may take up to 2-4 weeks to feel the benefit of this procedure.

Candidates

  • 18 years old
  • Failed surgical procedures
  • Herniations that can not be operated on
  • Conventional spine procedures have delivered no results