FAQ’s on Adhesiolysis in Las Vegas

Adhesiolysis is removal of scar tissue, which is also called lysis of adhesions. Scar tissue forms due to trauma, surgical procedures, inflammation, and/or infection. The adhesiolysis procedure is a minor surgical event, which is often done to relieve chronic neck and back pain. Around 1.7 million epidural adhesiolysis procedures are performed every year in the United States.

Who suffers from adhesions?

Scar tissue buildup is common for people with chronic low back pain due to narrowing of the spinal canal (spinal stenosis). This leads to local inflammation and subsequent scar tissue development. Around 33% of patients who have failed back surgery syndrome also have adhesions. These adhesions will affect mobility, cause persistent pain, and are obstacles to injection therapy.

Are adhesions of the spine painful?

Zygapophyseal joints (facet joints) connect the spinal bones (vertebrae) to one another. These small joints are located on each side of the vertebrae, and they form a space to allow nerve roots to exit from the spinal cord. When adhesions form near the nerve roots, it can constrict a nerve, reduce blood flow, and cause serious irritation. The pain associated with adhesions and nerve root compression is known as radiculopathy.

What can I expect before the adhesiolysis?

When you arrive at the medical facility, a nurse will go over the benefits and risks with you and have you sign a consent form. After you change into a gown, the nurse will place an IV catheter in your arm to give sedatives, fluids, and other medications. You will need someone to drive you home, so arrange for a driver.

What happens during the adhesiolysis procedure?

The doctor uses fluoroscopic guidance to assure correct placement of instruments. This is a form of real-time x-ray. After the doctor positions you on your stomach, the back is cleansed with a special antiseptic solution. Several medications will be injected to remove or dissolve the scar tissue. Medications are also injected to prevent inflammation and block pain. After removing the needle, the site is covered with a bandage.

What should I expect following the adhesiolysis procedure?

After the adhesiolysis procedure, you are monitored for about 20 minutes. We recommend that you rest for the remainder of the day, and gradually return to physical adhesions as tolerated. Be sure to keep the incision clean and dry, and do not soak in a hot tub or pool until it has healed.

What are the benefits of the adhesiolysis procedure?

The adhesiolysis procedure is safe and effective when used to reduce the symptoms associated with internal scarring. Symptoms associated with nerve root irritation will immediately resolve following removal of adhesions. In one large review of randomized studies, the adhesiolysis procedure was found to be superior to epidural steroid injection (ESI) for the treatment of chronic back pain associated with adhesions.

What are the risks and complications of adhesiolysis?

While risk are rare, they do occur. Complications include development of new adhesions, organ injury, infection, dural puncture, and bleeding. One common side effect of the adhesiolysis procedure is injection site pain, but this only lasts 24-48 hours and is relieved with use of ice packs.

Is adhesiolysis effective?

Adhesiolysis effectiveness is documented by research. One large clinical study showed that 100% of participants reported adequate pain relief within 3 months of the surgery, and over half of the patients had pain relief immediately after the procedure. Many clinical studies support adhesiolysis as an effective option for short-term pain relief related radiculopathy and back pain.

Resources

Igarashi, T., et al. (2004). Lysis of adhesions and epidural injection of steroid/local anaesthetic during epiduroscopy potentially alleviate low back and leg pain in elderly patients with lumbar spinal stenosis. Br J Anaesth, 181-87.

Racz, G., et al. (2008). Percutaneous lysis of epidural adhesions—Evidence for safety and efficacy. Pain Practice, 277-286.

Trescot, A., et al. (2007). Systematic review of effectiveness and complications of adhesiolysis in the management of chronic spinal pain: An update. Pain Physician, 129-146