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  • Epidural lysis of Adhesions/RACZ PROCEDURE

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    Old 04-25-2013, 07:29 PM   #1
    Strike554
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    Epidural lysis of Adhesions/RACZ PROCEDURE

    Hey everyone I am back. Just to let everyone know what has been going on...

    I had a microdiscectomy about 3 years ago. I had terrible nerve pain before surgery but the day after my Micro D it was gone forever....or so I thought.
    My back did feel funny for about a year after surgery. Didnt hurt just didnt feel 100% like my neurosurgeon said. That may be because my back wasnt in good condition strenght wise.

    Any ways back to my nerve pain. So I was never pain free for over a year and a half. Back to my normal activities, golf, running etc. Well one Monday morning after a Sunday afternoon round of golf I started to feel some tingling in my calf. That was about a year and a half ago....the rest is history. I have had nerve pain ever since. However it is probably a third of what it was when my disc was herniated at the L5-S1 level. I had an MRI and nothing shows. I have been to about 5 different docs in regards to this but all really do not know the EXACT answer of what is going on.

    My MRI does show "minimal enhancing epidural fibrosis abut s1 nerve root" and it is on my left leg the same leg that hurt prior to surgery.

    I have tried physical therapy, ice/heat, epidural steriod injections etc.

    Some docs believe scar may be the cause. Others are not so sure. Some docs say scar tissue continues to grow in the spinal canal and others do not.

    My question is I am thinking about trying the RACZ procedure? Has anyone ever done that?

    Input needed as I plan to have it later this month....


    Regards,

     
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    Old 07-21-2013, 08:25 AM   #2
    CT06405
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    Re: Epidural lysis of Adhesions/RACZ PROCEDURE

    Hi Striker,

    I have been curious about the RACZ procedure also. Did you have it done, and how extensive was it? I have read of different techniques, some where they inject substances to break up scar tissue the first day, then keep you overnight, then inject steroids and possibly other things the next day. Other doctors seem to do all the injections in one office visit.

    If you had it done, how did it work out?

     
    Old 07-26-2013, 06:34 AM   #3
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    Re: Epidural lysis of Adhesions/RACZ PROCEDURE

    A friend of mine had the RACZ procedure a week ago today, and the doctor said he was able to get rid of her scar tissue, so it seems for her it worked out. She said the procedure itself was very easy to go through and took about 30 minutes. Whether it will relieve all her pain or not is another story, as she has had 3 fusions, all separate operations.

    I think technique is very important with this procedure, as they are inserting a catheter into and upwards inside the spinal canal. If they don't do this well or are too rough, they can make things worse.

     
    Old 07-26-2013, 06:47 AM   #4
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    Re: Epidural lysis of Adhesions/RACZ PROCEDURE

    Please keep us updated on your friend's progress. I will be interested to hear how she is doing in a month or two. My friend 's "results" were catastrophic and she ended up much worse than prior to the procedure. I would agree with you that technique is very important. Oddly my friend's was done by a guy that is thought to be one of the leading experts of the topic of epidural fibrosis and the RACZ procedure....Maybe it depends on location too. Where were your friend's fusions?

     
    Old 07-26-2013, 07:02 AM   #5
    CT06405
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    Re: Epidural lysis of Adhesions/RACZ PROCEDURE

    Her fusions were at the 3 lowest levels of the lumbar spine. Now she has herniated discs up higher in her spine though. So it may be hard for her to tell if the RACZ helps or not, as she will still have pain, but possibly in a different location.

    Her spine has been one of those worst case scenarios we read about; fusions done over, muscle infections, loads of scar tissue, etc.

     
    Old 07-26-2013, 08:35 AM   #6
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    Re: Epidural lysis of Adhesions/RACZ PROCEDURE

    My friend just had one surgery ever on her spine, a PLIF at L4-L5. Now she has developed many additional issues since the procedure and cannot work. I think I told you about her earlier. She was a nurse anesthetist in a state where that profession is allowed to run the OR with an anesthesiologist in the room. She was well-familiar with the physicians and hospitals in her city...and still this happened. She went in thinking it would be a fairly simple procedure, and it changed her life forever.

    Sounds like your friend will have a better outcome. I hope so!

     
    Old 07-26-2013, 09:21 AM   #7
    CT06405
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    Re: Epidural lysis of Adhesions/RACZ PROCEDURE

    [QUOTE=teteri66;5203896]My friend just had one surgery ever on her spine, a PLIF at L4-L5. Now she has developed many additional issues since the procedure and cannot work. I think I told you about her earlier. She was a nurse anesthetist in a state where that profession is allowed to run the OR with an anesthesiologist in the room. She was well-familiar with the physicians and hospitals in her city...and still this happened. She went in thinking it would be a fairly simple procedure, and it changed her life forever.

    Sounds like your friend will have a better outcome. I hope so![/QUOTE]

    Has she described the issues that the procedure gave her in detail? Is it that her pain has increased?

     
    Old 07-26-2013, 09:16 PM   #8
    Strike554
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    Re: Epidural lysis of Adhesions/RACZ PROCEDURE

    Teter & CT,

    I hope you both are doing well. Sorry for the late reply but I had forgotten my username and password and just came to remember it.

    Here is an update on me:

    As you guys know I had an L5-S1 disc Herniation in 2009 that was 6mm and hitting my left nerve root. I had awful nerve pain for 9 months (tried all the conservative treatments) and was getting very depressed mentally. A few days after my micro- D surgery my pain was completely gone which was good because I was scared I had waited too long and may have had permanent nerve damage.

    Neurosurgeon cleared me 6 weeks later to basically do everything I was doing before except heavy weight lifting. (Heavy squats herniated my disc, along with other weight lifting exercises). I just picked up the hobby of golf and my friends were asking me every weekend to paly with them. I asked the neurosurgeon and he said it was fine to do that. I knew golf used a lot of twisting and torque but another buddy of mine who had a micro d also played golf and never complained of issues. I didn't think golf would cause an issue. I started playing maybe 6 months after my surgery.

    Anyways I played probably 35 times over a 5-7 month span with no issues. Then one morning AFTER a Sunday night round my calf started tingling. I almost passed out because I thought I had kissed my nerve pain gone forever. I almost had to leave work that day I was so upset and depressed.

    I have had the nerve pain ever since. This happened around Dec 2011. This means I was nerve pain free for about a year after surgery but then it started again and has been present Dec 2011. So I had an mri and it came back with no obvious signs of why my nerve should be irritated.

    My neurosurgeon kept saying inflammation and it should calm down but it never did so I looked for other opinions. All docs acted as if it would go away. 4 out of 5 docs said it was my scarring but the neuro still thinks it could be scarring plus something else like a possible "tear". He only brought up the tear theory about 4 months after I started complaining.

    I had a micro D so some people say if scarring was going to be an issue it would be about 6 weeks after surgery. My pain management docs say it can come to aggrevate later on. A few appts ago my neurosurgeon did say that pain like mine could be contributed to scarring since it happened so long after I was initially pain free.

    I know my L5-S1 has herniated before so its probably weaker but no tear showed up on my MRI. I just had a traditional tube MRI not the positional ones where you can sit, stand, etc. No tears small or large showed anywhere.

    They say a discography is the only way to really see a tear if it is under a grade 4 but discographys are a terrible test. They stick a needle in your disk and it basically destroys the makeup of the disk when they use pressure to diagnose the tear.

    THE FUNNY THING IS MY PAIN MANAGEMENT DOC IS DR RACZ. NOT GABOR RACZ BUT HIS SON TIBOR. His office is actually walking distance from my house. How crazy huh?

    I gave him my whole story and his response was it may be scarring but he wanted to try an epidural injection first. I let another pain management doc try an epidural on me after my new issue started and it did nothing. Didn't make it worse and didn't make it better.

    Dr. Racz said he does a different approach than most pain docs. He uses a blunt needle rather than a sharp and places it flush against the nerve root and soaks it then with steroid meds. I told him I wanted to skip that and go straight for the RACZ. His response was he would rather try the least invasive first and plus insurance prob wouldn't cover racz procedure without first trying injection. I went for it. All was well. Then about 7 days after my injection my nerve pain seemed to decrease and I just had tingling and numbness in my foot. I was freaking out because I was scared something was damaged.

    I had my follow up with dr racz and he said everything went perfectly find during my procedure and wasn't sure why it was tingling 7 days after my shot when it previous didn't. He said he thinks tingling can be a sign of healing? Has anyone heard of this? ANyways sometimes I only have tingling other I HAVE PAIN in my leg and sometimes both. It is never as bad as when I had a herniated disc though.

    But to answer your question CT I have not had the racz and don't plan too unless I am 100% sure its scarring causing my problem. The racz procedure is not a permanent fix anyways. Dr racz doesn't it in a two day span. The first day he inserts the catheter and injects saline. He then pulls out the needle and tapes the catheter to your back. The next day you come back in and he does the steroid.

    I think I am in good hands with my doctors all are very smart but nobody can pinpoint what exactly is causing this new pain. Is it possible my nerve could still be healing after its been over a year and a half? WHat are signs of nerve healing?

    ANy input is appreciated. Thanks guys!

    I have elected not to have the Racz procedure as of now because I am not 100% sure it is SCARRING. I have posted my MRI on another thread and will post it at the bottom of this one again.

     
    Old 07-27-2013, 06:41 AM   #9
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    Re: Epidural lysis of Adhesions/RACZ PROCEDURE

    Hi Strike,

    Thanks for your update. If your pain decreased and you have tingling instead, I would think that could be a sign that some of the scar tissue was dissolved, at least.

    Do you think the pain you still feel could be due to the nerve being under compression from the scar for awhile? Have you had an MRI since your injection to see if the scar tissue is there?

     
    Old 07-27-2013, 08:23 AM   #10
    Strike554
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    Re: Epidural lysis of Adhesions/RACZ PROCEDURE

    [QUOTE=CT06405;5204302]Hi Strike,

    Thanks for your update. If your pain decreased and you have tingling instead, I would think that could be a sign that some of the scar tissue was dissolved, at least.

    Do you think the pain you still feel could be due to the nerve being under compression from the scar for awhile? Have you had an MRI since your injection to see if the scar tissue is there?[/QUOTE]

    I'm not sure CT It's been a year and a half and I still don't have a conclusive reason on why I have pain. Apparently anyone who has ever damaged their spine will always have some type of symptoms according to my neuro. One physiatrist I saw who actually didn't perform injections did say epis my absorb some scarring but all the other docs say there is no clinical evidence of that. I may suggest having another MRI every few years just to know what's going on in there.

    CT if you are thinking about doing the racz have a skilled pain doc do it. It's not just an injection.

     
    Old 07-27-2013, 08:59 AM   #11
    CT06405
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    Re: Epidural lysis of Adhesions/RACZ PROCEDURE

    [QUOTE=Strike554;5204330]CT if you are thinking about doing the racz have a skilled pain doc do it. It's not just an injection.[/QUOTE]

    I agree, I would consult with several doctors and ask how many RACZ they have done and their exact technique, the solutions and type of steroid used, and what their entry route to the scarred area would be - and I will even do the same regarding a regular epidural steroid injection should I decide to get one.

    I don't think I'm a candidate for the RACZ. My synovial cyst removal was in the posterior compartment of the spine, between the facet joint and the nerve roots, where there is no room for a catheter; I'd have to have some things injected into scar there with a regular needle.

    I did have a good result with a Kenalog 40 injection into scar tissue on my wrist after having a foreign body reaction to some suture. It released the contraction and got rid of the scar permanently. I am hoping the same could happen if they get it into the right place in the scar tissue in the spine. However, I'm only 3 months postop so will wait awhile to allow for normal healing. But if I do it, I will probably only try it once and want it done right, so will consult with several people.

     
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