Epidural Lysis of Adhesions

Also called Racz procedure, this procedure is performed to remove excessive scarring in the epidural space. The epidural space is a thin area between the inside of the spine and the protective layer around the spinal cord. Scar tissue may restrict the
natural movement of nerves causing inflammation and pain.

WHAT PATIENTS ARE CANDIDATES FOR LYSIS OF ADHESIONS?
Patients who have had prior neck or back surgery but still have persistent pain may benefit from this procedure.Patients who have herniated disks that are not surgically correctable may also receive pain relief from this procedure.

HOW IS THE PROCEDURE PERFORMED?
You will be given conscious sedation through an IV (intravenous needle) inserted in your arm/hand on your admission to the facility where the procedure will be performed.You will be escorted to the surgical suite with the nurse and asked to lay on your stomach for the procedure . The MD and /or nurse will monitor your blood pressure, heart rate and respiratory rate (breathing) during the procedure.The physician will perform the procedure with a special x-ray machine called the fluoroscope to accurately visualize the anatomy. Then contrast dye will be injected to see the restrictive location or scarring area in your epidural space which may be causing your pain. Then a special catheter called the Racz catheter (www.epimedpain.com/)will be guided with x ray to the scarred area. A special medication called hyaluronidase is then injected to breakup the scarring as well as mechanical forces of the Racz catheter to break up the scarring. Finally, a mixture of steroids and local anesthetics will be injected to decreased the inflammation and provide pain relief after the lysis of adhesions.

WILL THE PROCEDURE BE PAINFUL?
Typically the sedation provided minimizes pain.Pain may increase in the first 48-72 hours because of the mechanical forces used to breakup the scarring.

WHAT ARE THE RISKS AND SIDE EFFECTS FROM THE RACZ LYSIS OF
ADHESIONS?
The most common risks are local pain from the needle and catheter which is a mild to moderate burning sensation lasting 2-7 days. More serious but extremely rare risks are bleeding, infection, nerve injury, paralysis and weakness in the lower extremities.

HOW LONG DOES IT TAKE FOR THE PROCEDURE TO WORK?
The beneficial effects are usually appreciated2-4 weeks following the procedure