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Analgesic Efficacy of Epidural Neuroplasty via Racz Catheter During Lumbar Fixation In Situ for Lumbosacral
Ahmed Shehata Abd Elhamid1, Mohammed Said Elsharkawy2, Mostafa Mohamed Shaheen2
1Anesthesia and Intensive Care Department, Faculty of Medicine, Port Said University, Port Said, Egypt, psu.edu.eg.
Background:
Effective pain management after lumbar fixation in situ is crucial for improving recovery and quality of life. Epidural neuroplasty via the Racz catheter is a potential method to enhance analgesia by targeting epidural inflammation and nerve compression. This work assessed the analgesic efficacy of epidural neuroplasty via a Racz catheter during lumbar fixation in situ for lumbosacral spondylolisthesis.
Methods:
This randomized, double-blinded, controlled study was conducted on 50 patients aged 18-65 years, of both sexes, who had Grade 1 spondylolisthesis, facet osteoarthropathy, and a small disc on radiological findings. Participants were randomly assigned to two equal groups. Group S received epidural neuroplasty via a Racz catheter during lumbar fixation, and Group C received conventional lumbar steroid injections.
Results:
Visual analog scale and Oswestry low back disability questionnaire scores were significantly diminished immediately postprocedure and at 1, 2, 4, and 6 m in Group S than in Group C (p < 0.05). Hypotension, paraesthesia, bleeding, and headache exhibited comparability between the two groups. The patient satisfaction level was significantly elevated in the Racz catheter group as opposed to the conventional lumbar group (p < 0.05).
Conclusions:
Epidural neuroplasty using a Racz catheter during lumbar fixation provides enhanced short-term analgesia, functional recovery, and patient satisfaction compared with conventional lumbar treatment in Grade-1 spondylolisthesis, without increased adverse effects, providing preliminary evidence that warrants validation in larger, long-term studies. Trial Registration: ClinicalTrials.gov identifier: NCT06684821.
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