What Is Lysis Of Adhesions?
Are you undergoing a lysis of adhesions procedure soon? Here’s what you should know about this treatment method and related conditions.
Lysis of adhesions is also known as adhesiolysis, percutaneous adhesiolysis, or the Racz procedure. It helps address conditions related to scar tissue around the spine. Scar tissue may be located in the area between the spinal cord (a thick cord of nervous tissue that sends information from all parts of the body to the brain) and the bones that surround and support it. This is known as the epidural space.
Foreign or potentially harmful matter (including scar tissue) in this region can pose a threat to your normal sensory or motor functions. Scar tissue may also affect the spinal nerves that connect the spine with the rest of your body. It may physically compress or impinge nervous tissue (which is known as spinal stenosis) or damage it chemically by causing the release of inflammatory molecules into the epidural space. Lysis of adhesions treats these risks by reducing or removing scar tissue.
Lysis of adhesions demonstrably improves symptoms of chronic pain conditions like failed back surgery and spinal stenosis.
Conditions Related To Lysis of Adhesions
Lysis of adhesion procedures are an increasingly popular option for some chronic pain patients.
Particularly, it can help manage symptoms of failed back surgery syndrome. This is a set of symptoms related to complications that occurred during back surgery. While back surgery is done to correct problems with muscles or nerves in the spinal region, it can also lead to issues down the line. In fact, moderate to severe scar tissue occurs in up to 25% of all spinal surgeries.
Other conditions related to spinal scar tissue include spinal stenosis. With this condition, the nervous tissue is mechanically impinged upon or compressed by the accumulation of scar tissue around it. Stenosis can result in pain, sensory disorders, or even the loss of motor control.
Lysis of adhesion procedures are mostly performed on the lower back. Regions of the spine affected by this include the sacroiliac joint, or the junction at which the spine meets the pelvis. However, it can also help in cases involving the neck (called the cervical spine). Cervical issues can lead to chronic pain in the neck or upper limbs.
Removing adhesions through lysis can help you return to normal function. It can also relieve pain, inflammation, and soreness for many patients. These results may last up to 12 weeks after treatment. A trial demonstrated promising results for using adhesiolysis for neck pain. This study showed that approximately 72% of the patients had moderate to zero pain six months following their lysis of adhesion procedure.
How Is Lysis Of Adhesions Performed?
When your doctor performs lysis of adhesions, they’re administering medications or other tools to break up (or lyse) scar tissue in an area. If you’re undergoing this procedure, here’s what you should know.
Your doctor will begin by injecting local anesthetic medications into the area to inhibit any pain during your procedure. They’ll visualize the scar tissue, and the nervous tissue in its immediate vicinity, using techniques like fluoroscopy or magnetic resonance imaging (MRI). This enhances their accuracy and effective lysis of the scar tissue. Alternatively, they may insert a thin probe with a small camera through the skin above the area to do the same.
Once they’ve determined the appropriate insertion and administration sites, they’ll deliver medications to the area. Medications may include saline and hyaluronidase, which breaks up the adhesions when injected into their proximity. Drugs that inhibit pain and inflammation, such as steroids or local anesthetics, may also be administered in the course of a lysis of adhesions procedure.
Lysis of adhesions risks
This procedure is safe and successful for many patients. As with any interventional treatment, though, there are risks. These are mainly related to inaccurate needle and catheter placement. If this occurs, it could puncture the membrane surrounding the spine, causing the disruption of sensory or motor functions.
Additional complications include temporary headache and discomfort in the injection area following the procedure. This discomfort may result from damage to skin, muscles, or minor nerves sustained during the procedure. The drugs used in lysis of adhesion procedures may also produce adverse effects in some patients. These include the side effects of steroids, which may range from abnormal emotional or behavioral responses, weight gain, immune system suppression, and gastrointestinal disorders. The use of local anesthetics may lead to chest discomfort, headaches, and sensory disturbances.
However, this procedure has been shown to be more effective than other similar techniques (e.g. stand-alone steroid injections) to treat the pain of failed back surgery syndrome, particularly in cases when conventional treatments haven’t worked. The use of imaging techniques such as MRI also reduces the risk of complications by ensuring adequate visualization of the injection site and nerves in the region. Always talk to your doctor about all of your questions, concerns, and risk factors you may have.
The lysis of adhesions procedure breaks up scar tissue that has built up around your spinal cord or spinal nerve(s).
Scar tissue may result in mechanical or chemical damage to these structures that leads to chronic pain or other neurological disorders. During a procedure, your doctor injects compounds into the area to break up (or lyse) the scar tissue. Medications such as local anesthetics and steroids may also be administered during the procedure. This may effectively treat pain and tissue damage in the relevant areas.
Lysis of adhesions can help address pain originating from the lower part of the spine, but may also help with chronic neck pain. This technique is effective and safe in the majority of cases, and offers short- to medium-term relief from pain.
To learn more about this procedure, talk to a pain specialist. You can find a pain doctor in your area by clicking the button below or looking for one in your area by using the tips here: http://paindoctor.com/pain-management-doctors/.
- Manchikanti L, Helm S, Pampati V, Racz GB. Cost Utility Analysis of Percutaneous Adhesiolysis in Managing Pain of Post-lumbar Surgery Syndrome and Lumbar Central Spinal Stenosis. Pain Pract. 2014.
- Manchikanti L, Singh V, Cash KA, Pampati V. Assessment of effectiveness of percutaneous adhesiolysis and caudal epidural injections in managing post lumbar surgery syndrome: 2-year follow-up of a randomized, controlle