Risks and complications of epidural neurolysis -- a review with case report

Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
K WagnerL Gerdesmeyer

Abstract

Racz's minimal invasive epidural catheter procedure, also known as "epidural neuroplasty" is not only utilized in patients suffering from failed spine surgery ("failed back surgery syndrome") but also increasingly applied to non-surgical back pain patients to prevent chronification or deterioration. Its hypothesized principle of action is local epidural lysis of adhesions, neurolysis of vertebral nerve roots and local lavage of proinflammatory mediators by repeated injection of local anesthetics, corticosteroids, hyaluronidase and hypertonic saline solution. However adverse events are well known to occur in epidural neuroplasty. Complications of epidural neuroplasty are due to the procedure itself or due to specific drugs-related side effects. Unintended dural puncture, administration of the drugs to the subarachnoid or subdural space, catheter shearing, infection and severe hemodynamic instability during application are most commonly observed adverse events. Complications related to the procedure itself occur immediately, while complications relating to drug administration show later onset. Within this context, we report a case of severe meningitis with neurologic sequelae in a patient who received Racz catheter-treatment for ...Continue Reading

Citations

Nov 8, 2007·Der Schmerz·R Jungbecker, M Zenz
May 23, 2008·The Clinical Journal of Pain·Ray M Baker
Nov 1, 2012·Pain Management·Standiford Helm
Jan 31, 2014·The Korean Journal of Pain·Frank LeeSteven P Cohen
May 28, 2008·Pain Practice : the Official Journal of World Institute of Pain·Gabor B RaczAndrea Trescot
May 25, 2010·Pain Practice : the Official Journal of World Institute of Pain·Koen Van BoxemJan Van Zundert
May 23, 2014·Journal of Korean Neurosurgical Society·Sung Bum KimYoung Jin Lim
Dec 7, 2018·Pain Management·Standiford Helm, Nebojsa Nick Knezevic

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