Caudal access percutaneous epidural adhesiolysis.

Abstract

Post-surgical epidural fibrosis and spinal stenosis (among others), as causes of low back and lower extremity pain; They greatly detract from the functional capacity of patients and considerably affect their state of health and well-being. The purpose of percutaneous epidural adhesiolysis is to reduce the harmful effects of epidural healing that prevents the arrival of mediation or therapy at the precise site of the cause of pain. This technique shows a substantial development over the time since it has been practiced, the numerous publications around it and the current scientific evidence. Percutaneous adhesiolysis for post-surgical syndrome, central spinal stenosis, chronic herniated disc or radiculitis in the lumbar spine enjoys level II evidence for the improvement of pain in both the short and long term. It is estimated that post-lumbar laminectomy syndrome, or pain after lumbar spine surgery, occurs in approximately 5-40% of patients undergoing surgical intervention. In the etiopathogenesis of low back and lower extremity pain, there is consensus in identifying as causes of pain: inflammation, edema, fibrosis, venous congestion, mechanical pressure of the posterior longitudinal ligaments, the annulus fibrosus and the spinal nerve, reduction or absence in spinal root nutrient supply and central sensitization.