Lysis of Adhesions – RACZ Catheter

Lysis of adhesions, also known as the RACZ procedure, is a minimally invasive procedure performed to remove excessive scarring in the epidural space, which is the thin area between the inside of the spine and the protective layer around the spinal cord. Scar tissue can cause restriction and inflammation of nerves, leading to persistent pain.

Who Are Candidates for Lysis of Adhesions?

Patients who have undergone prior neck or back surgery but continue to experience ongoing pain may benefit from this procedure. Additionally, patients with herniated disks that are not surgically correctable may find pain relief through lysis of adhesions.

How Is the Procedure Performed?

Upon admission to the facility, you will receive conscious sedation through an IV inserted in your arm/hand. You will be positioned on your stomach in the surgical suite, where the procedure will take place. The physician and/or nurse will monitor your blood pressure, heart rate, and respiratory rate throughout the procedure. Using fluoroscopy, a specialized X-ray machine, the physician will visualize the anatomy and inject contrast dye to identify the restrictive location or scarring in your epidural space that may be causing your pain. A RACZ catheter, guided by an x-ray, will then be used to reach the scarred area. Hyaluronidase, a special medication, will be injected to break up the scarring, aided by the mechanical forces of the RACZ catheter. Finally, a mixture of steroids and local anesthetics will be injected to reduce inflammation and provide pain relief after the lysis of adhesions.

Will the Procedure Be Painful?

Conscious sedation is administered to minimize pain during the procedure. However, you may experience increased pain in the first 48-72 hours due to the mechanical forces used to break up the scarring.

What Are the Risks and Side Effects of Lysis of Adhesions?

The most common risks include mild to moderate burning sensation at the needle and catheter insertion site, lasting 2-7 days. Serious but extremely rare risks include bleeding, infection, nerve injury, paralysis, and weakness in the lower extremities.

How Long Does It Take for the Procedure to Work?

The beneficial effects of the lysis of adhesions are typically noticed within 2-4 weeks following the procedure.