Epiduroscopic Adhesiolysis

Published on 10/03/2015 by admin

Filed under Neurosurgery

Last modified 10/03/2015

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Chapter 14 Epiduroscopic Adhesiolysis

With epiduroscopy, it is now possible to directly observe pathologic conditions such as epidural fibrosis, perineural scars, postoperative tissue changes, herniated nucleus pulposus, and hypertrophied ligamentum flavum. Several new procedures have also been made possible by epiduroscopy. Through manipulation of the equipment, the adhesion or fibrosis of the perineural area can be lysed. With insertion of an epidural catheter, chemical adhesiolysis can be performed. Also, drugs can be more effectively administered to a target nerve [1].

There are, however, a few limitations of epiduroscopic adhesiolysis. During epiduroscopy, the epidural space can be visualized only if it is kept distended by repeated injections of saline. More importantly, epiduroscopic procedures can elevate the intracranial pressure and intraorbital pressure. The procedural time requires 45 to 60 minutes for lumbar epidural space examination [25].