Epidural lysis of adhesions and myeloscopy.
Chronic low back pain is one of the most common ailments in modern medicine, with as many as 79% of patients with acute pain continuing to suffer with chronic or recurrent low back pain 1 year after its onset. Lumbar epidural fibrosis and post-lumbar laminectomy syndrome are increasingly recognized as being responsible for persistent low back pain. Estimations show that approximately 5% to 40% of lumbar surgeries result in failed back surgery syndrome. Epidural adhesiolysis with myeloscopy is an interventional technique based on the premise that the three-dimensional visualization of the contents of the epidural space provides the physician with the ability to directly visualize the structures, perform appropriate adhesiolysis, and administer drugs specifically to the target. This review describes pathophysiologic aspects, purposes and goals, rationale and indications, complications, and effectiveness of epidural lysis of adhesions with myeloscopy.
Manchikanti
Laxmaiah
L
Pain Management Center of Paducah, 2831 Lone Oak Road, Paducah, KY 42003, USA. drm@asipp.org
Singh
Vijay
V
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D004576:Electromyography / Q000379:methods; D004724:Endoscopy / Q000379:methods; D004824:Epidural Space / Q000473:pathology / Q000601:surgery; D005355:Fibrosis / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D013256:Steroids; D000267:Tissue Adhesions / Q000188:drug therapy / Q000473:pathology / Q000601:surgery
D000893:Anti-Inflammatory Agents; D013256:Steroids