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Nerve Adhesiolysis (Epidural Lysis of Adhesions)

What is Nerve Adhesiolysis?

Nerve Adhesiolysis or epidural lysis of adhesions is the treatment option available to deliver you from chronic back pain. The chronic back pain, especially in radiculopathy, as a result of the formation of scar tissue around the spinal nerve roots and results in compression, inflammation or infection of that area. The scar tissue also prevents the entry of medication to reach deep inside to relieve the pain. Normally, the pain can be relieved with the help of the epidural steroid injection directly on the lower posterior region of the spine. But, in the case of the scar tissue formation, the steroid in the above mentioned procedure would not travel to the correct localization to relieve pain.

Who can Benefit from Nerve Adhesiolysis?

Nerve Adhesiolysis was initially designed to treat the pain arises from radiculopathy secondary to the scar tissue formation in the epidural area, after a surgical procedure. But now, the pain in most of the following situations can be managed with the help of Nerve Adhesiolysis. The conditions are:

  • Spinal Stenosis
  • FBSS or Failed Back Surgery Syndrome
  • Facet pain
  • Degenerative arthritis of severe stage
  • Pain syndrome of spinal cord non-response to the spinal opiates
  • Vertebral compression fracture caused from the metastatic carcinoma of the spine.
  • Damage or degeneration of the spinal disks
  • Postlaminectomy syndrome of the neck region and of the back region
  • Leg pain
  • Thoracic disk related pain in the abdomen and also reflected on the chest wall

How is Nerve Adhesiolysis Preformed?

Nerve Adhesiolysis is a minimally invasive procedure that begins with assessing the patient’s condition and by getting the patient’s consent for the procedure. Later on, the patient is thoroughly examined for any other concomitant disease and a full blood analysis, urine analysis should be performed prior to the procedure. It is always better to perform a MRI scanning before the procedure to check for any anatomical particularities of the spinal cord.
After all these steps, the procedure can be started by giving a mild sedative to the patient. The patient is then changed into the prone position. The procedure requires visualization technique; hence, x-ray is used for this purpose. The contrast material is injected to localize the scar tissue, and then the catheter is inserted through the needle into the area with the medications to dissolve the scar tissue and to reduce the inflammation. The medications injected through the catheter are omnipaque, hypertonic saline, Hyaluronidase, local anesthetics, and steroids. The entire process lasts less than an hour and can go home immediately after the procedure.

What are the Outcomes?

The outcome of this minimally invasive procedure thought to be positive. The American Society of Interventional Pain Physicians found proof that this treatment can bring short-term relief in greater degree in comparison with its long-term pain relief. It is also believed that the use of this minimally invasive Nerve Adhesiolysis procedure can help the patients to decrease the use of painkillers and helps to improve the quality of life.

What are the Contraindications?

Every medical procedure has its limitations, Nerve Adhesiolysis also bounded by its own limitations or contraindications. The contraindication can be classified as absolute and relative contraindication. The absolute contraindication to Nerve Adhesiolysis or Epidural lysis of adhesions can be:

  • Formation of Syrinx
  • Sepsis or Severe immunocompromised state
  • Chronic or long-term infections
  • Coagulopathy
  • Localized infection around or in the area of procedure

The important contraindication, when the patient refuses to do it.

The relative contraindication can be in arachnoididtis. This condition might make the layers to be adhered to each other, when the contrast and other medications are used; there is a higher chance of it passing into subdural or subarachnoid space, which can increase the possibility of complications.

Meet Our Neurologists

At Neurological Associates of West Los Angeles our neurologists specialize in treating chronic back pain, especially in cases with radiculopathy, using minimally invasive procedures like Nerve Adhesiolysis.  Dr. Jordan, Dr. Chang, Dr. Franc, and Dr. O’Connor all diagnose and treat patients with chronic back pain or pain caused by radiculopathy where the formation of scar tissue around the spinal nerve roots result in pain.  If you suffer from chronic back pain, especially with radiculopathy, and need a specialist who is known for their expertise contact one of our neurologists to schedule an appointment at 310-829-5968.