open access

Vol 48, No 4 (2016)
Review articles
Published online: 2016-09-02
Submitted: 2014-12-16
Accepted: 2015-07-10
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A comparison of non-endoscopic and endoscopic adhesiolysis of epidural fibrosis

Martina Bellini, Massimo Barbieri
DOI: 10.5603/AIT.a2016.0035
·
Pubmed: 27595746
·
Anaesthesiol Intensive Ther 2016;48(4):266-271.

open access

Vol 48, No 4 (2016)
Review articles
Published online: 2016-09-02
Submitted: 2014-12-16
Accepted: 2015-07-10

Abstract

Low back and leg pain may be due to many causes, one of which is scarring in the epidural space. Epidural scarring may provoke this pain for many reasons: nerves may be trapped by scars, while veins in the epidural space press down upon the nerves and become enlarged, putting pressure on the nerves. Endoscopic and percutaneous epidural adhesiolysis allows one to eliminate the deleterious effects of scar formation, which can both physically prevent the direct application of drugs to nerve and provide relief in patients who have not responded to epidurals, physical therapy or medication. A search of the MEDLINE and Embase databases was conducted for the period between 1970 and 2014 using the search terms "adhesiolysis", "lysis of adhesions", "epiduroscopy", "epidural neuroplasty", "epidural adhesions", “radiofrequency lysis adhesion” and "epidural scar tissue" in order to identify articles relevant for this review. The purpose of this review is to describe the effectiveness and complications present in a comparison of non-endoscopic, endoscopic and pulsed radiofrequency endoscopic procedures in lysis of adhesions in epidural fibrosis.

Abstract

Low back and leg pain may be due to many causes, one of which is scarring in the epidural space. Epidural scarring may provoke this pain for many reasons: nerves may be trapped by scars, while veins in the epidural space press down upon the nerves and become enlarged, putting pressure on the nerves. Endoscopic and percutaneous epidural adhesiolysis allows one to eliminate the deleterious effects of scar formation, which can both physically prevent the direct application of drugs to nerve and provide relief in patients who have not responded to epidurals, physical therapy or medication. A search of the MEDLINE and Embase databases was conducted for the period between 1970 and 2014 using the search terms "adhesiolysis", "lysis of adhesions", "epiduroscopy", "epidural neuroplasty", "epidural adhesions", “radiofrequency lysis adhesion” and "epidural scar tissue" in order to identify articles relevant for this review. The purpose of this review is to describe the effectiveness and complications present in a comparison of non-endoscopic, endoscopic and pulsed radiofrequency endoscopic procedures in lysis of adhesions in epidural fibrosis.

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Keywords

Key words: adhesiolysis, pulsed radiofrequency, Racz, Raffaeli

About this article
Title

A comparison of non-endoscopic and endoscopic adhesiolysis of epidural fibrosis

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 48, No 4 (2016)

Pages

266-271

Published online

2016-09-02

DOI

10.5603/AIT.a2016.0035

Pubmed

27595746

Bibliographic record

Anaesthesiol Intensive Ther 2016;48(4):266-271.

Keywords

Key words: adhesiolysis
pulsed radiofrequency
Racz
Raffaeli

Authors

Martina Bellini
Massimo Barbieri

References (48)
  1. Masopust V, Häckel M, Netuka D, et al. Postoperative epidural fibrosis. Clin J Pain. 2009; 25(7): 600–606.
  2. Coskun E, Süzer T, Topuz O, et al. Relationships between epidural fibrosis, pain, disability, and psychological factors after lumbar disc surgery. Eur Spine J. 2000; 9(3): 218–223.
  3. Smuck M, Benny B, Han A, et al. Epidural fibrosis following percutaneous disc decompression with coblation technology. Pain Physician. 2007; 10(5): 691–696.
  4. Talbot L. Failed back surgery syndrome. BMJ. 2003; 327: 985–986.
  5. Hussain A, Erdek M. Interventional pain management for failed back surgery syndrome. Pain Pract. 2014; 14(1): 64–78.
  6. Matsumoto T. [Racz Spring Guide Catheter epidural lysis of adhesions and percutaneous neuroplasty]. Masui. 2014; 63(7): 766–774.
  7. Manchikanti L, Bakhit CE. Percutaneous lysis of epidural adhesions. Pain Physician. 2000; 3(1): 46–64.
  8. Hammer M, Doleys DM, Chung OY. Transforaminal ventral epidural adhesiolysis. Pain Physician. 2001; 4: 153–166.
  9. Lee F, Jamison DE, Hurley RW, et al. Epidural lysis of adhesions. Korean J Pain. 2014; 27(1): 3–15.
  10. Igarashi T, Hirabayashi Y, Seo N, et al. Lysis of adhesions and epidural injection of steroid/local anaesthetic during epiduroscopy potentially alleviate low back and leg pain in elderly patients with lumbar spinal stenosis. Br J Anaesth. 2004; 93(2): 181–187.
  11. Manchikanti L, Rivera JJ, Pampati V, et al. Spinal endoscopic adhesiolysis in the management of chronic low back pain: a preliminary report of a randomized, double-blind trial. Pain Physician. 2003; 6(3): 259–267.
  12. Richardson J, McGurgan P, Cheema S, et al. Spinal endoscopy in chronic low back pain with radiculopathy. A prospective case series. Anaesthesia. 2001; 56(5): 454–460.
  13. Manchikanti L, Boswell MV, Rivera JJ, et al. [ISRCTN 16558617] A randomized, controlled trial of spinal endoscopic adhesiolysis in chronic refractory low back and lower extremity pain. BMC Anesthesiol. 2005; 5: 10.
  14. Donato ADi, Fontana C, Alemanno D, et al. Epiduroscopy in treatment of degenerative chronic low back pain: A prospective analysis and follow-up at 60 months. Clinical Research and Regulatory Affairs. 2010; 27(3): 69–74.
  15. Kim JD, Jang JH, Jung GH, et al. Epiduroscopic laser disc ad neural decompression. J Neurosurf Rev. 2011; 1: 14–19.
  16. Richter E, Abramova M, Cantu F, et al. Anterior epiduroscopic neural decompression: Eight-center experience in 154 patients. European Journal of Pain Supplements. 2012; 5(S2): 401–407.
  17. Raffaeli W, Righetti D. Surgical radio-frequency epiduroscopy technique (R-ResAblator) and FBSS treatment: preliminary evaluations. Acta Neurochir Suppl. 2005; 92: 121–125.
  18. Raffaeli W, Righetti D, Andruccioli J, et al. Epiduroscopy and radiofrequency technique: the Raffaeli–Righetti technique. The Pain Clinic. 2013; 19(4): 185–191.
  19. Geurts JW, Kallewaard JW, Richardson J, et al. Targeted methylprednisolone acetate/hyaluronidase/clonidine injection after diagnostic epiduroscopy for chronic sciatica: a prospective, 1-year follow-up study. Reg Anesth Pain Med. 2002; 27(4): 343–352.
  20. Murai K, Suzuki H, Igarashi T, et al. Epiduroscopy for intractable low back pain or sciatica in operated and non-operated back patients: results from The Japan Society of Epiduroscopy. The Pain Clinic. 2013; 19(4): 163–169.
  21. Sluijter ME. The role of radiofrequency in failed back surgery patients. Curr Rev Pain. 2000; 4(1): 49–53.
  22. Boswell MV, Trescot AM, Datta S, et al. American Society of Interventional Pain Physicians. Interventional techniques in the management of chronic spinal pain: evidence-based practice guidelines. Pain Physician. 2005; 8(1): 1–47.
  23. Boswell MV, Trescot AM, Datta S, et al. American Society of Interventional Pain Physicians. Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. Pain Physician. 2007; 10(1): 7–111.
  24. Abdi S, Datta S, Trescot AM, et al. Epidural steroids in the management of chronic spinal pain: a systematic review. Pain Phys. 2007; 10: 185–212.
  25. Park CH, Lee SHo, Jung JY. Dural sac cross-sectional area does not correlate with efficacy of percutaneous adhesiolysis in single level lumbar spinal stenosis. Pain Physician. 2011; 14(4): 377–382.
  26. Manchikanti L, Cash KA, mcMamnus CD, et al. The preliminary results of a comparative effectiveness evaluation of adhesiolysis and caudal epidural injections in managing chronic low back pain secondary to spinal stenosis: a randomized, equivalence controlled trial. Pain physician. 2009; 12: E341–E354.
  27. Manchikanti L, Singh V, Cash KA, et al. A comparative effectiveness evaluation of percutaneous adhesiolysis and epidural steroid injections in managing lumbar post surgery syndrome: a randomized, equivalence controlled trial. Pain Physician. 2009; 12: E335–E368.
  28. Gerdesmeyer L, Wagenpfeil S, Birkenmaier C, et al. Percutaneous epidural lysis of adhesions in chronic lumbar radicular pain: a randomized, double-blind, placebo-controlled trial. Pain Physician. 2013; 16(3): 185–196.
  29. Choi E, Nahm FS, Lee PB. Evaluation of prognostic predictors of percutaneous adhesiolysis using a Racz catheter for post lumbar surgery syndrome or spinal stenosis. Pain Physician. 2013; 16: E531–E536.
  30. Takeshima N, Miyakawa H, Okuda K, et al. Evaluation of the therapeutic results of epiduroscopic adhesiolysis for failed back surgery syndrome. Br J Anaesth. 2009; 102(3): 400–407.
  31. Pereira P, Severo M, Monteiro P, et al. Results of Lumbar Endoscopic Adhesiolysis Using a Radiofrequency Catheter in Patients with Postoperative Fibrosis and Persistent or Recurrent Symptoms After Discectomy. Pain Pract. 2016; 16(1): 67–79.
  32. Chua NHL, Vissers KC, Sluijter ME. Pulsed radiofrequency treatment in interventional pain management: mechanisms and potential indications-a review. Acta Neurochir (Wien). 2011; 153(4): 763–771.
  33. Chopra P, Smith HS, Deer TR, et al. Role of adhesiolysis in the management of chronic spinal pain: a systematic review of effectiveness and complications. Pain Physician. 2005; 8(1): 87–100.
  34. Talu GK, Erdine S. Complications of epidural neuroplasty: a retrospective evaluation. Neuromodulation. 2003; 6(4): 237–247.
  35. Fibuch EE. Percutaneous epidural neuroplasty: cutting edge or potentially harmful pain management? Reg Anesth Pain Med. 1999; 24(3): 198–201.
  36. Manchikanti L. The role of neural blockade in the management of chronic low back pain. Pain Digest. 1999; 9: 166–181.
  37. Trescot AM, Chopra P, Abdi S, et al. Systematic review of effectiveness and complications of adhesiolysis in the management of chronic spinal pain: an update. Pain Physician. 2007; 10(1): 129–146.
  38. Gerdesmeyer L, Lampe R, Veihelmann A, et al. [Chronic radiculopathy. Use of minimally invasive percutaneous epidural neurolysis according to Racz]. Schmerz. 2005; 19(4): 285–295.
  39. Richter H. Is the so-called epidural neuroplasty (Racz catheter) a harmless procedure? In: Rochirurgie DGF. ed. Deutsche Gesellschaft fur Neurochirurgie. , Strasburg 2005.
  40. Wagner KJ, Sprenger T, Pecho C, et al. [Risks and complications of epidural neurolysis -- a review with case report]. Anasthesiol Intensivmed Notfallmed Schmerzther. 2006; 41(4): 213–222.
  41. Helm S, Racz GB, Gerdesmeyer L, et al. Effectiveness of spinal endoscopic adhesiolysis in post lumbar surgery syndrome: a systematic review. Pain Physician. 2009; 12(2): 419–435.
  42. Amirikia A, Scott IU, Murray TG, et al. Acute bilateral visual loss associated with retinal hemorrhages following epiduroscopy. Arch Ophthalmol. 2000; 118(2): 287–289.
  43. Pawl R. Arachnoiditis and epidural fibrosis: the Relationship to chronic pain. Current Review of Pain. 1998; 2(2): 93–99.
  44. Kemaloglu S, Ozkan U, Yilmaz F, et al. Prevention of spinal epidural fibrosis by recombinant tissue plasminogen activator in rats. Spinal Cord. 2003; 41(8): 427–431.
  45. Nanjayan SK, Swamy GN, Yallappa S, et al. Arachnoiditis following caudal epidural injections for the lumbo-sacral radicular pain. Asian Spine J. 2013; 7(4): 355–358.
  46. Manchikanti L, Pampati V, Bakhit CE, et al. Non-endoscopic and endoscopic adhesiolysis in post-lumbar laminectomy syndrome: a one-year outcome study and cost effectiveness analysis. Pain Physician. 1999; 2(3): 52–58.
  47. Helm S, Hayek SM, Colson J. Spinal endoscopic adhesiolysis in post lumbar surgery syndrome: an update of the assessment of the evidence. Pain Physician. 2013; 16(2 Suppl.): SE125–SE150.
  48. Van Boxem K, Cheng J, Patijn J, et al. 11. Lumbosacral radicular pain. Pain Pract. 2010; 10(4): 339–358.

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