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Modified Epidural Adhesiolysis Protocol for the Treatment of Refractory Low Back Pain - A Case Series
Brian R Connolly1, Jacqueline Curbelo1, Sanketh Kichena2
1Department of Anesthesia, University of Texas Health Science Center, San Antonio, TX.
Background:
Scar tissue can form within the epidural space following surgical trauma, infection, annular tearing, hematoma formation, and disc herniation. When epidural fibrosis (EF) is present, it can render nerve roots more susceptible to entrapment, compression, and tension-each of which can potentially contribute to low back and radicular pain in the lower extremities. In the past, several different epidural adhesiolysis protocols have been described to treat such pain.
Case Report:
Three patients with chronic low back and radicular pain, and evidence of EF underwent a modified epidural adhesiolysis protocol over a single visit. All 3 patients reported greater than 50% pain relief for at least 3 months following treatment with the modified epidural adhesiolysis protocol.
Conclusion:
These case results suggest that the proposed modified epidural adhesiolysis can provide significant relief of axial and radicular pain in a cost effective and accessible manner for this patient population.
