[Epidurolysis - an old-new procedure]

Area of Science:

• Neurosurgery
• Pain Management
• Spinal Surgery

Background:

• Epidural adhesions, stemming from inflammation, disc degeneration, or post-surgical scarring, impede spinal nerve root mobility and cause chronic radicular and low back pain.
• Limited conservative treatment options and severe pain often impair patients' quality of life.

Purpose of the Study:

• To introduce epidurolysis as a cost-effective, minimally invasive therapeutic option for epidural adhesions in public hospitals.
• To present a case report demonstrating the efficacy of lumbar epidurolysis for post-surgical scarring and persistent pain.

Main Methods:

• A case report of a 71-year-old female patient with persistent left lower limb pain post-lumbar surgery.
• Diagnosis of epidural scarring via lumbar spine MRI and physical examination.
• Performance of lumbar epidurolysis under a one-day protocol.

Main Results:

• The patient experienced significant pain reduction immediately after epidurolysis and at a 6-week follow-up.
• Complete cessation of painkiller use post-intervention.
• Established evidence supporting epidurolysis for postlaminectomy syndrome (Level I) and spinal pain from disc herniation/stenosis (Level II).

Conclusions:

• Epidurolysis is a highly effective, safe, and cost-effective procedure for treating epidural adhesions.
• The intervention significantly improves patient outcomes and quality of life, with positive social implications.
• Lumbar epidurolysis presents a viable long-term solution for chronic spinal pain conditions.