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Epidurolysis - RACZ

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Epidurolysis is used to dissolve scar tissue around trapped nerves in the epidural space: i.e. it reduces the amount of epidural fibrosis. It was pioneered by Dr. Gabor Racz.

Scarring (adhesions) in the epidural (peridural/extradural) space is common after spinal surgery. It may be severe and cause symptomatic compression of nerve roots as they exit the spinal cord.

The epidurolysis involves injection of a mixture of local anaesthetic (lidocaine/bupivicaine), steroid (triamcinolone: Aristocort/Kenalog; methylprednisolone: depo-medrol/depo-medrone), X-ray contrast agent, the enzyme hyaluronidase (hyalase) and concentrated salt solution.

Hyaluronidase is a naturally occurring enzyme which acts on hyaluronic acid, which is the "glue" that binds connective tissues together.The procedure involves an injection of contrast agent into the epidural space in order to locate the scar tissue. Then an implanted catheter is used to deliver hyaluronidase safely and also to perform some mechanical lysis of the scar tissue.