Epidurolysis is indicated in the treatment of congenital or acquired spinal canal stenosis (e.g. adhesions from previous spinal surgery or failed back surgery syndrome).
Epidurolysis
Epidurolysis is a minimally invasive technique that involves, under fluoroscopic guidance and local anaesthesia or mild sedation, the introduction of a catheter/electrode that, through mechanical and pharmacological lysis, allows the debridement of nerve roots, thus reducing painful symptoms. It is also possible, through the tip of this particular electrode, to perform pulsed ganglionic radiofrequency at several levels.
CASE STUDY EPIDUROLYSIS
Mario, 50, has suffered from lumbar back pain with irradiation to the lower limbs (lumbosciatica) for years. Mario has undergone two back operations in the past years: 1) hernia removal (discectomy), 2) vertebral stabilisation. Despite these two operations, Mario did not solve his problem; on the contrary, his symptoms worsened, so he turned to Dr Lo Bianco. After careful evaluation of the radiological imaging (lumbar magnetic resonance imaging), the electromyographic study and a thorough specialist examination, Dr Lo Bianco proposed an epidurolysis operation. This is a minimally invasive procedure that involves, under fluoroscopic guidance and after local anaesthesia or mild sedation, the introduction of a catheter that, by means of mechanical and pharmacological lysis, allows the nerve roots compressed or stretched by surgical scarring to be debrided, thus reducing painful symptoms.
“I had lost hope of returning to a normal life after two unsuccessful surgeries. Doctor Lo Bianco solved my problem with a less invasive operation, drastically reducing the pain that no longer allowed me to live.” Mario
Epiduroscopy
Epiduroscopy (Spinal Endoscopy or Periduroscopy) is a technique that is part of the diagnostic and therapeutic methods for the front and anterolateral lumbar peridural space.
Spinal endoscopy is among the most effective mini-invasive techniques, before progressing to more complex antalgic techniques, indicated for resolving chronic pain conditions in the lumbar spine and lower limbs.
Spinal Endoscopy (or Epiduroscopy or Periduroscopy) in the caudal vertebra is a procedure that is indicated in those patients who have FBSS (failed back surgery syndrome, a definition that identifies all those patients who continue to have pain after surgery on the spine).
Other rationales for an epiduroscopy are canal stenosis or fibrosis of the spinal nerve roots, always before proceeding to more complex antalgic techniques.
THE TECHNIQUE
The technique of epiduroscopy involves the use of a small fibroscope, the epiduroscope, which is an instrument that contains optical fibres inside and is inserted into the peridural space and used to assess and remove scar tissue, adherent or located near nerves and responsible for pain.