Epidural Lysis of Adhesions and Epiduroscopy

In this concise yet comprehensive presentation, the speaker explores the concept of adhesive lysis, a technique pioneered in the ’80s by Gabor Racz to alleviate persistent pain post-back surgery. Emphasizing the use of various medications to expand the epidural space, the goal is to alleviate nerve root compression and subsequent pain, common in post-surgical and non-surgical scenarios. The talk progresses to address the evolution of this technique, the role of directed catheter use in epidural steroid injections, and advanced treatments involving electrical stimulation. Indications, patient selection, and the significance of specific medication combinations like hyaluronidase and hypertonic saline in enhancing treatment efficacy are discussed. The speaker also delves into epiduraloscopy, highlighting its diagnostic and therapeutic advantages, such as direct visualization of epidural space and targeted drug delivery. The presentation concludes by examining failback surgery syndrome, its causes, and various treatment options, emphasizing the importance of a patient-centered approach in managing chronic back pain.