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apartipilo 09-28-2007 08:11 PM

Lysis of adhesions in low back
I know lysis means removal; adhesions are parts of scar tissue that stick to the exiting nerves from your spine. These adhesions supposedly cause a lot of pain because they irritate the nerves and cause them to be in a constant state of inflammmation because nerves are meant to glide. If scar tissue binds to these nerves, the nerves are NOT happy campers because as they try to glide ( say when you bend your back to sit) the nerves are repeatedly pulled when there's no "give" and are then damaged.
Who can solve this nasty problem? Physical therapy may help but usually doesn't. It claims to "break down" this scar tissue but there's no evidence to support this. So then, what can be done?? I've heard only that lysis of adhesions can be done either by: 1. injections of steroids ( I don't even know if that works ) OR 2. surgical removal, sometimes by way of laser ( which also is controversial).
Can anyone tell me if there's some hope out there. I think my problem right now is exactly that-- scar tissue around the nerves after 2 back surgeries-- lumbar fusion followed, 3 yrs later, by removal of hardware.

csciguy 10-13-2011 08:32 AM

Re: Lysis of adhesions in low back
I'm going through this exact same thing right now. 2 back surgeries. Scarring around L5/S1. I've done the Epidural steroid injections and have had zero luck with them. My remaining options are the Racz procedure, Selective Nerve Root Block, or an implant. I'm currently doing PT and am not sure if that is helping me or not. Are you seeing a pain management specialist now?

Sundedo 10-16-2011 10:25 PM

Re: Lysis of adhesions in low back
I was looking into having lysis done before having my fusion. As I understood the procedure, they would inject a fluid into the scar tissue to dissolve the adhesions. They would possibly also use some physical means (he mentioned scraping) to remove/separate the binding scar tissue.

In my research, I found mixed results and decided it wasn't for my condition. What are your symptoms and what treatments have you had for them?

csciguy 10-17-2011 09:03 AM

Re: Lysis of adhesions in low back
My LOA would be essentially the same thing, except for the scraping. They would inject enzymes that would destroy some of the scar tissue.

Symptoms are pain down my right leg due to failed back surgery. There is a verifiable mass of scar tissue that the nerve is caught up in. As the day goes on, the nerve gets inflamed to the point where the pain is unbearable. Lying down relieves 95% of this pain however, but really isn't feasible.

Treatment wise, I have had multiple ESI shots, as well as months of PT. My other options are to have a selective nerve root block (which sounds frightening), the Racz, or an electrode implant.

teteri66 10-17-2011 05:42 PM

Re: Lysis of adhesions in low back
[B]My other options are to have a selective nerve root block (which sounds frightening), the Racz, or an electrode implant. [/B]

Your doctor must be a fan of the lysis procedure, because many doctors will not recommend it or perform the procedure. It is not performed all that often because it is rarely successful --at least for any type of long-term results.

A nerve block is easy compared to a lysis procedure, but I don't see how a nerve block would help, other than to identify the pain. It would certainly not provide any kind of long-term relief.

The Racz procedure is just another name for a lysis of adhesions or a epiduolysis procedure.

I think the electrode you're referring to is having a spinal cord stimulator implanted for pain control.

csciguy 10-18-2011 08:31 AM

Re: Lysis of adhesions in low back
Yes, he's a fan. He's done a good bit of the research on the procedure itself and was involved pretty extensively with it.

I am in fact referring to having a spinal cord stimulator put in. I'm not sure how that would help in this situation either.

Are there any other options for scar tissue that is causing pain down one of the legs? We are 99% certain that this is fact the cause of all my problems...

teteri66 10-18-2011 12:20 PM

Re: Lysis of adhesions in low back
No, options are very limited when it comes to scar tissue.

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