ABSTRACT
Treatment of chronic back pain, specifically for postsurgical patients and patients with epidural fibrosis, continues to be a challenge. The effectiveness of epidural steroid injections in patients with epidural fibrosis has not been studied. Further surgery for peridural scarring has resulted in disappointing results, with success rates as low as 12%. 1–3 One of the techniques described to effectively manage chronic low back pain secondary to epidural fibrosis is adhesiolysis of epidural scar tissue. 4–18 The purposes of percutaneous epidural lysis of adhesions are to eliminate deleterious effects of a scar, which can physically prevent direct application of drugs to nerves or other tissues, and to assure delivery of high concentrations of injected drugs to the target areas. In a 2002 review describing the role of decompressive surgery in managing chronic pain of spinal origin after lumbar surgery, Phillips and Cunningham 19 reported that no form of surgical treatment or adhesion lysis procedure for this diagnosis has proved to be safe and effective.
