Epidural lysis of adhesions

Frank Lee, David E. Jamison, Robert W. Hurley, Steven P. Cohen

Research output: Contribution to journalReview article

Abstract

As our population ages and the rate of spine surgery continues to rise, the use epidural lysis of adhesions (LOA) has emerged as a popular treatment to treat spinal stenosis and failed back surgery syndrome. There is moderate evidence that percutaneous LOA is more effective than conventional ESI for both failed back surgery syndrome, spinal stenosis, and lumbar radiculopathy. For cervical HNP, cervical stenosis and mechanical pain not associated with nerve root involvement, the evidence is anecdotal. The benefits of LOA stem from a combination of factors to include the high volumes administered and the use of hypertonic saline. Hyaluronidase has been shown in most, but not all studies to improve treatment outcomes. Although infrequent, complications are more likely to occur after epidural LOA than after conventional epidural steroid injections.

Original languageEnglish (US)
Pages (from-to)3-15
Number of pages13
JournalKorean Journal of Pain
Volume27
Issue number1
DOIs
StatePublished - Jan 1 2014

Keywords

  • Epidural adhesiolysis
  • Epidural lysis of adhesions
  • Epidural neuroplasty
  • Epiduroscopy
  • Failed back surgery syndrome

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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