A review of the role of epidural percutaneous neuroplasty. (3rd December 2018)

• Record Type: Journal Article
• Authors: Helm, Standiford; Knezevic, Nebojsa Nick
• Is Part Of: Pain management. Volume 9:Number 1(2019)
• Page Start: 53
• Page End: 62
• Publication Date: 2018-12-03
• Subjects: epidural scarring -- failed-back surgery syndrome -- hyaluronidase -- hypertonic saline -- low back pain -- nerve entrapment -- neuroplasty -- percutaneous adhesiolysis -- peridural membrane -- Racz procedure; Pain -- Treatment -- Periodicals; 616.047205
• DOI: 10.2217/pmt-2018-0042
• Languages: English
• ISSNs: 1758-1869

Abstract

Degeneration, whether from age or postsurgical, in the ventral and lateral epidural space can lead to irritation of both the nerve roots and of the nerves present in the epidural space, the peridural membrane and the posterior longitudinal ligament. This irritation is often accompanied by mild scarring. Neuroplasty is a specific procedure designed to relieve this irritation. The effectiveness of neuroplasty is not affected by the extent of spinal stenosis. Neuroplasty can be performed in the lumbar, thoracic and cervical spine, and using caudal, transforaminal and interlaminar approaches. Postprocedural home exercises are an integral part of the procedure. There are multiple high-grade studies positive for the effectiveness and safety of neuroplasty. Neuroplasty should be offered prior to surgery in patients with persistent back and/or extremity pain.