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Epidural fibrosis is the formation of scar tissue inside the epidural space and around the nerves. This most commonly occurs following surgery. Adhesiolysis is freeing the nerves from the scar tissue with a catheter under x-ray guidance and injecting medication close to the nerve root so that it will be delivered appropriately to reduce the inflammation. What happens during the procedure? The patient is taken into the holding area where an intravenous infusion is started so that a small dose of sedation can be given. Following this the patient is taken into the procedure room and placed on the operating table on their stomach. At this time, a small dose of sedation is provided. Appropriate preparation is carried out with sterile technique. The physician numbs a small area of skin with a local anesthetic. Following this, the physician puts a special needle known as a RK needle into the caudal epidural space (tail bone). Following this, dye is injected to see how the nerve roots are filling and the dispersion of the dye indicating the scar tissue. At this time a special catheter, which is a spring guided wire known as a Racz catheter, is slowly passed into the epidural space and into the scar tissue area on multiple occasions. After separating the nerve roots from the scar tissue, the catheter is positioned so the medicine will be delivered into the area of irritation of the nerve and again dye is injected to see that nerve roots are clear and filling properly without obstruction of the scar tissue. Following this, a local anesthetic and steroids are injected into the epidural space. What happens after the procedure? Following the initial procedure, the patient is transferred to the recovery room and is closely monitored for any side effects. Occasionally, numbness or weakness in the legs may be noted that will last for about 1-2 hours. You were given a number of medications during the procedure. These sometimes include sedatives, narcotics, local anesthetics, steroids and other medications. Any of these drugs or the procedure itself sometimes can cause side effects, including drowsiness, temporary numbness, weakness and soreness. What to do after the procedure? Rest a few hours and use assistance if needed. Resume activity as tolerated, but do not overdo it. Resume your regular diet. Restrictions: Do not drive or operate machinery for at least 12 hours. Do not make important decisions for 12-24 hours after treatment. Walk with assistance as long as numbness, weakness or drowsiness is present. Notify the office if you have: Excessive or abnormal bleeding, persistent chills or fever over 100 degrees or if there is no major change in pain pattern or level. Emergency: In case of emergency, call (954) 493-5048. If you are unable to reach the physician, report to the nearest emergency room and request them to inform the physician at Fort Lauderdale Pain Medicine. Few
other things: Resume your usual medication(s). Apply ice as instructed.
If the IV site becomes painful, place warm towels on the site for
20 minutes, 2-3 times a day. |
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1930 NE 47th Street, Suite 300 Fort Lauderdale, FL, 33308
