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Epidural lysis of adhesions. Korean J Pain 2014 Jan;27(1):3-15

Date

01/31/2014

Pubmed ID

24478895

Pubmed Central ID

PMC3903797

DOI

10.3344/kjp.2014.27.1.3

Scopus ID

2-s2.0-84891821167 (requires institutional sign-in at Scopus site)   74 Citations

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.

Author List

Lee F, Jamison DE, Hurley RW, Cohen SP

Author

Robert W. Hurley MD, PhD Adjunct Professor of Anesthesiology and CTSI in the Anesthesiology department at Medical College of Wisconsin