Adhesiolysis is one of the procedures used by pain specialists, like Novus Pain & Spine Center in Lakeland, Florida, to treat pain resulting from scar tissue.
Adhesiolysis is also called “epidural lysis of adhesions,” because the procedure breaks up scar tissue. Furthermore, it’s called the “Racz Procedure,” named for the doctor who developed the procedure to remove or divide tissue adhesions in the lumbar region of the spine (lower back).
What Is an Adhesion?
An adhesion is a band of scar tissue that binds two parts of body tissue together that are not normally joined together. Pain typically results from an adhesion because of restricted movement, pressure on a nerve, or an obstruction.
Adhesiolysis is a procedure that breaks up the scar tissue, thus relieving the pain.
What Causes Adhesions?
An adhesion can form during the body’s healing process after any tissue disturbance. This can be from surgery, infection, trauma, or even radiation.
It’s not uncommon for patients suffering from back pain caused by scar tissue to have previously undergone back surgery. This is because scar tissue can aggravate nearby nerve roots causing intense pain that may radiate to the buttocks, legs, and feet.
What Is Adhesiolysis?
Adhesiolysis is a minimally-invasive surgical procedure that breaks up adhesions (scar tissue) and treats the affected area with steroids and other medications. The procedure is considered both safe and effective in dissolving scar tissue.
How Is Adhesiolysis Performed?
While under mild sedation, adhesiolysis is performed with the aid of an X-ray to view the spine. Contrast dye is injected into the area to clearly see the area that is affected by scar tissue buildup.
If nerve root inflammation is the source of a patient’s pain, a needle is placed into the lower back, and a steroid is injected to relieve the pain.
If scar tissue is responsible for the pain, a catheter is inserted and medication is injected to destroy the scar tissue, resulting in the reduction of inflammation and pain. If needed, a balloon can be inserted to help create more room around the compressed nerve. And sometimes, pulsed radiofrequency is used to encourage nerve regeneration if needed.
Although a needle is used with this procedure, it is important to note that the needle is not inserted into the spine. Instead, it is placed in the posterior of the back, which improves the distribution of medication to the affected regions.
What Conditions Are Treated with Adhesiolysis?
There are different spine and back conditions that adhesiolysis is beneficial in treating, including:
- Spinal surgery syndrome.
- Spinal stenosis.
- Lumbar and cervical pain.
- Leg pain.
Spinal surgery syndrome can occur after spinal surgery when pressure on spinal nerves from scar tissue causes chronic pain in the lumbar region of the spine (lower back). The first line of treatment is usually an injection of steroids. However, adhesiolysis often provides more effective and longer-lasting pain relief. While steroid injections may help to reduce the inflammation, they do not dissolve scar tissue.
Spinal stenosis is a narrowing of the spinal canal that compresses the nerves, causing pain, muscle weakness, and motor problems. These symptoms may be caused by both scar tissue and inflammation of the spinal nerves. Following adhesiolysis, patients typically report less back pain, while some patients report no pain at all.
What Is the Outcome of Adhesiolysis?
The American Society of Interventional Pain Physicians guidelines for chronic spinal pain management shows there is strong evidence to indicate the effectiveness of adhesiolysis with epidural steroids for short-term and long-term pain control where other methods of treatment have been unsuccessful. Studies show an overall improvement in patient health. Patients also reported their pain medication use decreased, and their physical and mental health improved, after undergoing adhesiolysis.
As with all medical procedures, there are potential risks of complications. Adhesiolysis is considered an appropriate treatment for many patients who suffer from back pain. You should consult your pain doctor to see if the benefits outweigh the risks in your specific situation.
Novus Spine & Pain Center
Novus Spine & Pain Center is in Lakeland, Florida, and specializes in treating the pain resulting from scar tissue. By using a comprehensive approach and cutting edge therapies, we work together with patients to restore function and regain an active lifestyle, while minimizing the need for opiates.
Epidural lysis of adhesions (Wikipedia)
Dr. Gabor Racz (Wikipedia)
What causes adhesions? (WebMD)