Zeitschrift für Wirbelsäulen- und Neurochirurgie

Innovative Treatment For Chronic Lumbar Back Pain

Stephens M, Sarayusa A, Mortensen Z, Nagy L and Racz G

Radiculopathy can occur in a variety of patients ranging from complications of obesity to sports injuries to a combination of repetitive stress movements with post- traumatic disc disorder. In the case of three teenage patients, each of these causes contributed to their pain that led them to present in Emergency Departments, Family Medicine clinics, and eventual referral to Pediatric Neurosurgery. Various approaches were administered to help with the pain of these teenagers that included local steroid injection and chiropractic adjustments that ultimately contributed to no lasting pain relief. Each patient was considered to have chronic lower back pain and deemed a candidate to receive an innovative treatment option to help manage the back pain. The patients were all referred to receive epidural lysis of adhesions (LOA) which provided the lasting relief of the pain that the patients were seeking. LOA is a procedure that includes using a needle, Racz catheter, and injectable contrast guided with fluoroscopy to locate the appropriate spinal level of the radiculopathy and associated scarred entrapment of nerves. LOA utilizes the injection of hyaluronidase dissolved in normal saline to free the entrapped nerve so that a local anesthetic/steroid solution can be injected to block sensory signals and provide pain relief.