Epidural lysis of adhesions is also called decompressive neuroplasty, percutaneous adhesiolysis or the Racz procedure, named after the surgeon who invented it.
It loosens up scar tissue (adhesions) to alleviate pain and help the spread of pain medication in the epidural space. It is a minimally invasive procedure and done on an outpatient basis.
What Causes Adhesions in the Epidural Space?
Epidural adhesions are scar tissue formed in the epidural space surrounding the spinal cord’s outermost layer, called the dura mater. Epidural adhesions are often caused by leakage of cerebrospinal fluid (CSF) into the lumbar spine’s epidural space following spine surgery or from a bulging disc. Disc material can also leak into the epidural space following a tear and cause an inflammatory response that causes scar tissue to form. This procedure can also treat radicular pain and spinal stenosis. Scar tissue entraps the nerves that leave the spinal cord to supply other regions of the body. Adhesions can bring about persistent back or leg pain. Physicians can break up the scar tissue both mechanically and chemically with the use of a special catheter and combination of medications. An enzyme, hyaluronidase is sometimes used to dissolve the adhesions.