What Is RACZ Caudal Neurolysis?

Lysis of epidural adhesions is a treatment option for patients suffering from chronic low back pain and radicular pain (pain that shoots down the thigh, calf, and sometimes into the foot). Adhesions may form after back surgery or from leakage of disc material into the epidural space. Oftentimes, the adhesions and disc material surround a nerve root, causing inflammation and severe pain.

The word “lysis” means to destroy or break up material. Using a spring-wound or steerable catheter, the doctor is able to break up the adhesions, flush out disc material, and direct medication onto the inflamed area and nerve root. Lysis of epidural adhesions is indicated after conservative treatments such as medication and epidural steroid injections have failed to relieve your pain.

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Before and After the Procedure and the Risks

Before the Procedure

Do not eat or drink anything after midnight the day before the procedure. If you are on medications, you may take them with sips of water. If you are a diabetic, discuss your medication with your doctor. You may need to stop taking certain medications several days before the procedure. Please remind the doctor of all prescription and over-the-counter medications you take, including herbal and vitamin supplements. The doctor will tell you if and when you need to discontinue the medications. Tell the doctor if you develop a cold, fever, or flu symptoms before your scheduled appointment.

After the Procedure

You may experience some abdominal pain, bruising, and swelling at the incision site. This will be treated with medication. You can also apply an ice pack to the area. Keep the area clean and dry to help prevent skin infection. You may experience a tingling or electrical buzzing sensation in the area of your usual pain. Although your pain may not totally go away, you should have enough relief to help you function better. You may experience some muscle discomfort where the needles were place. This may be treated with a mild pain reliever such as Tylenol.

Do not drive for the remainder of the day. Please have an adult drive you home or accompany you in a taxi or other public transportation. Depending on how you feel, you may resume normal activities and return to work in one to three days.

Procedure Risks

The risks are minimal but potentially include: Infection, spinal cord compression, meningitis, spinal fluid leak, bleeding, movement of the wires, and hardware failure.