The epidural space is a potential layer surrounding the spinal cord. Many factors including trauma, chronic inflammation,
previous surgery, and previous infections can cause scarring and adhesions in the epidural space. This in turn may cause
pain, weakness, and numbness of the affected level.
The condition most frequently involves the nerves within the lumbar spine and cauda equina. Signs and symptoms indicate
the involvement of multiple nerve roots, and include low back pain, radicular pain, tenderness, sphincter disturbances, limited
trunk mobility, muscular spasm or contracture, motor sensory and reflex changes. Typically, the pain is characterized as
constant and burning. In some cases the pain and disability are severe, leading to analgesic dependence and chronic
invalidism.
This particular procedure is performed to destroy the scars. The patient will be placed in a prone position, and with the use of
live X-ray the sacral hiatus near the tailbone will be identified. After injecting a small amount of numbing medication in your
skin, a needle will be directed in the epidural space. Then, a special catheter will be directed toward the suspected level. The
extent of scarring will be evaluated in real time under fluoroscopy by injection of contrast material and observing its spread
pattern. At this time, a guide wire, special solutions, or the catheter itself will be used to destroy and take down the scar
tissues. The procedure might take 30-45 minutes.
After the procedure is completed, Band-Aids will be placed at the injection sites, and a nurse will monitor the blood pressure
and pulse and will review the discharge instructions with the patient before going home.
