Scar Tissue Removal Surgery
Percutaneous epidural adhesiololysis, also known as the removal of scar tissue, is used to treat patients with refractory low back pain caused by scarring. Epidural scarring can occur as the result of a previous tear in the disc which inflamed the nerves, the inflammation may resolve, but scarring may persist without prior surgery.
Blood clot formation may occur in the epidural space during to the post-op period. After spine surgery, scar tissue may adhere to the nerve roots. Scar tissue around the nerve can inhibit nutrients from reaching the nerves, causing hypersensitivity. Mechanical compression can also occur. The scar tissue is formed in the epidural space. The potential space located in between the spinal cord and spinal canal.
The procedure is performed under x-ray guidance. After local anesthesia is administered to the skin, a needle is advanced to the proper anatomical location. A specialized catheter is advanced through the needle. Contrast dye is administered to outline the scar tissue.
There have been numerous alternatives to the next sequences of the treatment forms. Initially hypertonic saline was infused daily for three days to “break up” the scar tissue. Initial studies were promising, but unfortunately could not be reproduced.
Dangerous side effects were seen and the technique was abandoned. A special medication, Hyaluronidase, was then used to break down the scar. This procedure was also questioned with conflicting outcomes. Now the catheter is manipulated through the scar when possible, and subsequent steroids are administered to decrease inflammation around the area of scar disruption. The patient is returned to the recovery room and observed for a short period, and discharged home the same day.
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