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Removal of a torn Racz catheter from lumbar epidural space
1Pain Management Center of Paducah, Kentucky, USA.
Background And Objectives:
Epidural adhesiolysis, described by Racz et al. (1) utilizing a double-contrast injection technique, provides an epidurogram that clearly delineates the area of adhesions and furnishes a means to perform lesion-specific lysis of adhesions utilizing a flexible wire-embedded catheter.
Methods:
A caudal/lumbar epidurogram followed by lysis of adhesions was attempted in a 68-year-old male suffering with severe, low back pain with radiation into both lower extremities, using R-K needle and the Racz catheter (Medic Epimed, Gloversville, NY) under fluoroscopic visualization.
Results:
After the cannulation and during the attempts to manipulate, the Racz catheter was sheared and was retained in the epidural space. After unsuccessfully attempting to remove it endoscopically, it was successfully removed using arthroscopy forceps.
Conclusions:
This case report illustrates a difficult situation with a sheared and retained epidural catheter which could not be removed utilizing the standard techniques but was successfully removed without any residual problems using arthroscopy forceps.
