Epidural Adhesiolysis

What you should know

Epidural adhesiolysis is surgery to treat long-term back or leg pain. The epidural space is the area between your spinal cord and the bones that make up your spine. Pain may be caused by scar tissue in the epidural space pressing on nerves in your spine. Epidural adhesiolysis may be used to remove the scar tissue.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • You may have bleeding, infection, or trouble breathing after surgery. Spinal fluid may leak from the site. During the surgery, your spinal cord, blood vessels, or nerves may be injured. Your pain may return even after this surgery. You may have an allergic reaction to medicine used during surgery. Steroids may increase your risk of infection. If you have a blood disorder or take certain medicines, you may have a higher risk for problems during or after surgery.

  • Without treatment, your pain may get worse and cause more problems. You may have permanent muscle or nerve damage. You may also have problems moving your legs or be unable to control your bladder or bowel.

Getting Ready

The week before your surgery:

  • Arrange to have someone drive you home from the hospital. Do not drive yourself home.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • You may be given dye to help the epidural space show up better in pictures. Tell the caregiver if you have ever had an allergic reaction to contrast dye.

  • Tell your caregiver if you know or think you might be pregnant.

  • You may need to have blood or urine tests, an EKG, chest x-ray, and other tests. Ask your caregiver for more information about these and other tests you may need. Write down the date, time, and location of each test.

  • Write down the correct date, time, and location of your procedure.

The night before your surgery:

  • You may be given medicine to help you sleep.

  • Ask caregivers about directions for eating and drinking.

The day of your surgery:

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

Treatment

What will happen:

  • You may be given medicine to help you relax or make you sleepy. Your caregiver may also inject medicine to numb the skin over your spine. He will insert a needle between the vertebrae in your lower back. Your caregiver may need to pull out, reinsert, or change the position of the needle to find the epidural area.

  • Your caregiver will inject a dye to make nerves and scar tissues in the spinal area easier to see on fluoroscopy (a type of x-ray). He will insert a catheter and small tools in the epidural space. He may use a small scope with a monitor to see where to place the catheter. He will slowly move the catheter to try to free the nerves from the scar tissue.

  • Your caregiver may inject a fluid to dissolve the scar tissue. He may also inject a mixture of anesthetic and steroid medicine through the catheter. When the surgery is finished, the needle will be taken out. Your caregiver will use stitches to keep the catheter from being pulled out. The catheter will be covered with a cap and antibiotic medicine. A bandage will cover the area to keep it clean and dry.

After your surgery:

You will be taken to a recovery room until you are fully awake. Caregivers will watch you closely for any problems. Your blood pressure, heart rate, and ability to move will be monitored closely. Do not get out of bed until your caregiver says it is okay. When caregivers see that you are okay, you will be taken back to your hospital room. A caregiver may remove the bandages soon after your surgery to check your catheter.

Contact a caregiver if

  • You cannot make it to your surgery on time.

  • You have a fever.

  • Your skin is itchy, swollen, or has a rash.

  • You have questions or concerns about your surgery.

Seek Care Immediately if

  • Your legs, feet, or other parts below the waist feel numb, tingly, or weak.

  • Your signs and symptoms get worse.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Epidural Adhesiolysis (Precare)

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