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Strike554 11-13-2012 02:34 PM

Racz procedure??
Has anyone ever had the Racz Procedure done? I have MILD epidural fibrosis "ABUT" s1 nerve root.

I was pain free for over a year and a half as far as sciatic pain goes after a micro Discectomy.

Mri shows no signs of tear.

Neurosurgeon advised he can refer me to a pain mgmt doc for an injection of Saline to break it up.

After research I think he is referencing racz procedure or epidural adheloysis.

ANy input is appreciated

teteri66 11-13-2012 04:40 PM

Re: Racz procedure??
My surgeon told me not to do it because the procedure is extremely painful, and the rate of success is so low. I would say it might be worth trying...but the only person I know who had the procedure is very much worse off than before she had it...and she wishes she had never attempted it. But if your doctor described having a saline injection, I would think that is different.

The procedure for Lysis of Adhesions is to go in with a catheter with a tip on the end, usually fed up through the sacral hiatus until it reaches the area of the adhesion. Then the catheter is moved around in an attempt to break up the scar tissue. This is the part that is extremely painful. Often, the procedure is repeated a number of times over several weeks'time.

The procedure is fraught with potential problems. Nerves can be damaged, and there is always the risk of arachnoiditis with every procedure that enters the spinal canal. After all this, chances are fairly high that the scar tissue will just grow back.

Unless you are absolutely certain that scar tissue is causing your pain, I would think long and hard before agreeing to this procedure.

I'm still not convinced that scar tissue is your pain generator. People don't usually develop scar tissue issues so long after surgery, and after a period post surgery where you were pretty much pain-free.

But I'd discuss it with your surgeon. He may have something else in mind.

Strike554 11-13-2012 04:50 PM

Re: Racz procedure??

Sometimes I think you know more than some of my doctors. The mri does say that epidural fibrosis is "abut" or touching. Arent the nerves super sensitive.

If something touches it like scar tissue wouldnt that be enough to irritate it?

You already have read my MRI. In your honest opinion what do you think it is. It is driving me crazy and getting me depressed again

gmak 11-13-2012 05:29 PM

Re: Racz procedure??
Hey strike, mild epidural fibrosis, to me doesnt sound like a problem even if abut. It sounds to me in my warped honest opinion that with it removed then you could more easily have epidural steroid injections. But, i have more than mild epidural fibrosis. My pm years ago would drill through it to give me what he called " the blue plate special" & i do have arach, i guess, so he didnt do me any favors. Saline though. How would that work? Highpressure? Research it. Im sure its out there somewhere! God bless you. So sorry that your hurting again. I feel the same way about teteri! I value her opinions & help ever so greatly! Get better soon & let us know what happens Thank you.

Ps i DID see racz on video out there

Strike554 11-13-2012 06:16 PM

Re: Racz procedure??
gmak and teter,

My surgeon doesnt give two craps about me. I can tell. He just shrugs off the fact Im in pain bc my mri doesnt show any problems. It may not be scar tissue. All of my docs at first completely threw that theory out. They only then acknowledged it after pt, stretching etc didnt work.

I dont know what to do. Im at my whits end. I just cant give up. I am trying to stay strong.

teteri66 11-13-2012 06:58 PM

Re: Racz procedure??
Is your surgeon a neurosurgeon or an orthopedic spine surgeon?

Have you ever heard of a clinic in the Dallas area called Minimally Invasive SpineCare in Irving? There are four surgeons and four interventional pain management doctors....

Strike554 11-13-2012 07:02 PM

Re: Racz procedure??
He is a neuro from big baylor hospital in Dallas. Supposedly specializes in herniated disc. I have heard of that clinic by the way is it good?

teteri66 11-13-2012 09:46 PM

Re: Racz procedure??
Why don't you take a look at their website and see what you think. The doctor who founded it, Dr. Douglas Won, seems to be particularly well-regarded....they have a type of online evaluation. It might be worth your time to pay them a visit.

Have you consulted with any other surgeons since you had the surgery?

gmak 11-14-2012 03:16 AM

Re: Racz procedure??
[QUOTE=Strike554;5088487]gmak and teter,
My surgeon doesnt give two craps about me. I can tell. He just shrugs off the fact Im in pain bc my mri doesnt show any problems. It may not be scar tissue. All of my docs at first completely threw that theory out. They only then acknowledged it after pt, stretching etc didnt work.
I dont know what to do. Im at my whits end. I just cant give up. I am trying to stay strong.[/QUOTE]

Hey strike, You are strong! I think its just a matter of communication and time. When you have pain we dont want to wait for clarification or for another appointment so that we can get our questions answered & procedures explained. Thats all that you need to do or can do @ this time as i understand this situ.. Write all your questions down about exactly what the procedure is. Your drs dont know exactly whats wrong but its a step by step process. Thats what informed consent is. They cannot proceed until you sign on dotted line and you dont sign until you are & feel informed. This may take longer than they like, but its your body! So what if you need 2 or 3 different dr opinions to feel informed. Even when informed and understand the procedure you may or may not want it done or the drs may recommend something that makes more sense to you. They say this is our offer you say no dice or great idea. I keep thinking of people that have muscle spasms so bad it pulls the bone over just a fraction & now touches nerve. The dr trys
muscle relaxers, NSAIDS & person doesnt get better. These people would get offered the big back surgeries of the past and take the offer. Who can say if the very next bottle of muscle relaxers would have worked! Get all the info, then decide. Decide informed though. So, thats why we are all here. To learn,support others decisions, you need a little more assurance of whats wrong. i.e. can epidural fibrosis touching a nerve cause the pain im having? Does this procedure pros & cons make sense to me, does it add up? Imo, time, information, patience, & drs dont want to wait sometimes. Some can be my way or the highway. Informed consent for a procedure means that they cant do any thing unless you agree & understand. Please dont let anyone make up your mind. So, get what you need to decide, try not to get upset, you may even need another opinion, but stay as level headed as possible so that you can make an informed choice.Meanwhile, we are here for you. This is just what i think, you will know. Please update on whats happening, thanks.

Strike554 11-14-2012 09:29 AM

Re: Racz procedure??
gmak and teter,

You guys truly make me feel better. I am a very detailed person and I hate not knowing the EXACT reason of my pain. I guess sometimes life just brings us disappointments. I know you guys both have pain or else you wouldnt be on this forum either.

I have an appt with a new Dr this Monday the 19th. I am going to ask him specifically if scar tissue is just touching my nerve can it cause pain. Or if its a small tear or something.

Would you guys happen to know if discongenic pain or a disc "tear" can cause leg pain. I know the outer ring of my disc does have nerve fibers, but according to one doctor if my disc was torn I would have back pain which I have none of. No tear shows on MRI either


gmak 11-14-2012 09:47 AM

Re: Racz procedure??
Hi strike, maybe get a different radiologist to read MRI? I have very important things that would lead me in a new direction if the radiologist would have commented on them? Gnawimg pain= the pain I cant abide! Dr that specializes in the condition i supposedly have says gnawing pain caused by CSF being unable to drain. A scope surgery exists to fix this. My MRI report doesnt mention it. If i knew i could get that scope surgery. If a new radiologist found cause of pain you would know what to do, yes? Ps if you look on dermatome map @ S1 it shows which areas are affected.

Strike554 11-14-2012 03:13 PM

Re: Racz procedure??

The physiatrist believes it is my s1 nerve root affected. He did an evaluation and based on what I said and what he found he believes that is the nerve responisble for my pain. That is the same nerve the scar tissue is abut.

He doesnt believe there is a tear, at first he thought it was weak muslces causing inflammatory molecules in my blood aggrevating my nerve. Second appt he then said it was scar tissue.

teteri66 11-14-2012 05:24 PM

Re: Racz procedure??
Rather than depending on your PM for a diagnosis, why don't you get a second opinion from an orthopedic spine surgeon in your area?

Strike554 11-14-2012 06:54 PM

Re: Racz procedure??

I tried to get a second opinion from another neuro about 5 months ago. He refused to see me since I had a previous surgery from another neuro. I guess for liability reasons. Is there an advantage of seeing an ortho.for a second opinion rather than neuro

teteri66 11-14-2012 08:05 PM

Re: Racz procedure??
Definitely...for the simple reason that it is an orthopedic spine surgeon, not a neurosurgeon...and they may have a different way of accessing your problems.

As a general rule, while I realize it does not apply in all cases, neuros are much more reluctant to take on someone who had surgery with another doctor. They are just "fussier."

Before you think about attempting a potentially dangerous procedure like a lysis of adhesion, I would definitely get another opinion from a spine surgeon.

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