Epidural Lysis of Adhesions

What is epidural lysis of adhesions?

The epidural space is a thin area between the inside of the spine and the protective layer around the spinal cord. Scars or adhesions may form in the epidural space after an injury or back surgery. These adhesions can restrict the movement of nerves and cause nerve compression or irritation. If you have symptoms such as low back pain or pain shooting into your arms or legs, you may have nerve irritation secondary to epidural adhesions. Epidural lysis of adhesions is designed to release the tension on the nerves by reducing inflammation and dissipating scar tissues surrounding the nerves.

How is the procedure performed?

You will be lying face down on your stomach for this procedure. Local anaesthetic will be administered to numb the skin over your buttock area. A small caliber, flexible catheter is then inserted through an opening at the tailbone (sacral hiatus) and directed under X-ray guidance to the affected nerve root.

What medications are used for this procedure?

Local anaesthetics, steroids or hyaluronidase or a combination of the three will be injected through the catheter to the affected nerve root. Steroids are effective in reducing the swelling and inflammation around the nerve roots. Hyaluronidase is a chemical enzyme that may help to reduce adhesions.

What should I do after the procedure?

Your doctor will teach you simple exercises to help maintain the movement of nerves in and out of the spinal canal. This type of exercise-induced nerve root movement is referred to as Neural Flossing. These exercises allow you to regain flexibility and strength and prevent the restriction of affected nerve roots and the resulting return of your pain.