Role of adhesiolysis in the management of chronic spinal pain: A systematic review of effectiveness and complications

Pain Physician

Volumn 8, Issue 1, 2005, Pages 87-100

  Chopra, Pradeep ^a,b,c,f   Smith, Howard S ^d   Deer, Timothy R ^e   Bowman, Richard C ^e  

^a BROWN UNIVERSITY   (United States)

^b BOSTON UNIVERSITY SCHOOL OF MEDICINE   (United States)

^c Interventional Pain Mgmt Center   (United States)

^d ALBANY MEDICAL COLLEGE   (United States)

^e Center for Pain Relief   (United States)

^f NONE   (United States)

Author keywords

Chronic low back pain; Epidural fibrosis; Percutaneous adhesiolysis; Post lumbar laminectomy syndrome; Spinal endoscopic adhesiolysis; Spinal pain; Spinal stenosis

Indexed keywords

BETAMETHASONE; BETAMETHASONE ACETATE; BUPIVACAINE; CLONIDINE; CORTICOSTEROID; HYALURONIDASE; LIDOCAINE; LOCAL ANESTHETIC AGENT; METHYLPREDNISOLONE; METHYLPREDNISOLONE ACETATE; SODIUM CHLORIDE; STEROID;

ADHESIOLYSIS; ANALGESIA; CHRONIC PAIN; CLINICAL TRIAL; COCHRANE LIBRARY; CONSERVATIVE TREATMENT; DRUG EFFICACY; EMBASE; ENDOSCOPY; EVIDENCE BASED MEDICINE; FUNCTIONAL ASSESSMENT; HEADACHE; HUMAN; INFECTION; LAMINECTOMY; LEG PAIN; LONG TERM CARE; LOW BACK PAIN; MEDLINE; META ANALYSIS; METHODOLOGY; NONHUMAN; OUTCOMES RESEARCH; PHYSIOTHERAPY; PRURITUS; PSYCHOLOGICAL ASPECT; RANDOMIZATION; RASH; REVIEW; SHORT COURSE THERAPY; SPINAL PAIN; SYSTEMATIC REVIEW; TREATMENT OUTCOME;

EID: 14944364749     PISSN: 15333159     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (103)

1. Manchikanti L, Staats PS, Singh V, Schultz DM, Vilims BD, Jasper JF, Kloth DS, Trescot AM, Hansen HC, Falasca TD, Racz GB, Deer T, Burton AW, Helm S, Lou L, Bakhit CE, Dunbar EE, Atluri SL, Calodney AK, Hassenbusch S, Feler CA. Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician 2003; 6:3-80.
2. Carey TS, Garrett JM, Jackman A, Hadler N. Recurrence and care seeking after acute back pain. Results of along term follow up study. Med Care 1999; 37:157-164.
3. Wahlgren DR, Atkinson JH, Epping-Jordan JE, Williams RA, Pruitt SD, Klapow JC, Patterson TL, Grant I, Webster JS, Slater MA. One-year follow up of first onset low back pain. Pain 1997; 73:213-221.
4. Vingard E, Mortimer M, Wiktorin C, Pernold RPTG, Fredriksson K, Nemeth G, Alfredsson L; Musculoskeletal Intervention Center-Norrtalje Study Group. Seeking care for low back pain in the general population: A two-year follow up study: Results from the MUSIC-Norrtalje Study. Spine 2002; 27:2159-2165.
5. Ferguson SA, Marras WS, Gupta P. Longitudinal quantitative measures of the natural course of low back pain recovery. Spine 2000; 25:1950-1956.
6. Croft PR, Lewis M, Papageorgiou AC, Thomas E, Jayson MI, Macfarlane GJ, Silman AJ. Risk factors for neck pain: A longitudinal study in the general population. Pain 2001; 93:317-325.
7. Kuslich SD, Ulstrom CL, Michael CJ. The tissue origin of low back pain and sciatica: A report of pain response to tissue stimulation during operation on the lumbar spine using local anesthesia. Orthop Clin North Am 1991; 22:181-187.
8. Boden SD, Bholman HH (eds,). The Failed Spine. Etiology and therapy,. Lippincott Williams & Wilkins, Philadelphia, 2003.
9. Alkalay RN, Kim DH, Urry DW, Xu J, Parker TM, Glazer PA. Prevention of postlaminectomy epidural fibrosis using bioelastic materials. Spine 2003; 28:1659-1665.
10. Ross JS, Roberston JT, Fredrickson RC, Petrie JL, Obuchowski N, Modic MT, deTribolet N. Association between peridural scar and recurrent radicular pain after lumbar discectomy: Magnetic resonance evaluation. Neurosurgery 1996; 38:855-861.
11. Hoyland JA, Fremont AJ, Jayson MI. Intervertebral foramen venous obstruction. A cause of periradicular fibrosis? Spine 1989; 14:558-568.
12. Fritsch EW, Heisel J, Rupp S. The failed back surgery syndrome. Reasons, intraoperative findings, and long-term results: A report of 182 operative treatments. Spine 1996; 21:626-633.
13. North RB, Campbell JN, James CS, Conover-Walker MK, Wang H, Piantadosi S, Rybock JD, Long DM. Failed back surgery syndrome: 5-year follow-up in 102 patients undergoing repeated operation. Neurosurgery 1991; 28:685-691.
14. Dullerud R, Graver V, Haakonsen M, Haaland AK, Loeb M, Magnaes B. Influence of fibrinolytic factors on scar formation after lumbar discectomy. A magnetic resonance imaging follow-up study with correlation performed 7 years after surgery. Spine 1998; 23:1464-1469.
15. Cervellini P, Curri D, Volpin L, Bernardi L, Pinna V, Benedetti A. Computed tomography of epidural fibrosis after discectomy. A comparison between symptomatic and asymptomatic patients. Neurosurgery 1988; 6:710-713.
16. Pawl RP. Arachnoiditis and epidural fibrosis: The relationship to chronic pain. Curr Rev Pain 1998; 2:93-99.
17. Songer M, Ghosh L, Spencer D. Effects of sodium hyaluronate on peridural fibrosis after lumbar laminectomy and discectomy. Spine 1990; 15:550-554.
18. Coskun E, Suzer T, Topuz O, Zencir M, Pakdemirli E, Tahta K. Relationships between epidural fibrosis, pain, disability, psychological factors after lumbar disc surgery. Eur Spine J 2000; 9:218-223.
19. LaRocca H, Macnab I. The laminectomy membrane: Studies in its evolution, characteristics, effects and prophylaxis in dogs. J Bone Joint Surg BR 1974; 56:545-550.
20. McCarron RF, Wimpee MW, Hudkins PG, Laros GS. The inflammatory effects of nucleus of nucleus pulposus: A possible element in the pathogenesis of low back pain. Spine 1987; 12:760-764.
21. Cooper RG, Freemont AJ, Hoyland JA, Jenkins JP, West CG, Illingworth KJ, Jayson MI. Herniated intervertebral disc-associated periradicular fibrosis and vascular abnormalities occur without inflammatory cell infiltration. Spine 1995; 20:591-598.
22. Parke WW, Watanabe R. Adhesions of the ventral lumbar dura. Adjunct source of discogenic pain? Spine 1990; 15:300-303.
23. Olmarker K, Rydevik B. Pathophysiology of spinal nerve roots as related to sciatica and disc herniation. In Herkowitz HN, Garfin SR, Simeone FA (eds). Rothman-Simeone Studies, The Spine. WB Saunders, Philadelphia, 1999, pp 159-172.
24. Rydevik BL. The effects of compression on the physiology of nerve roots. J Manipulative Physiol Ther 1992; 15:62-66.
25. Phillips FM, Cunningham B. Managing chronic pain of spinal origin after lumbar surgery. Spine 2002; 27:2547-2553.
26. Manchikanti L, Bakhit CE. Percutaneous lysis of epidural adhesions. Pain Physician 2000; 3:46-64.
27. Viesca C, Racz G, Day M. Spinal techniques in pain management: lysis of adhesions. Anesthesiol Clin North America 2003; 21:745-766.
28. Manchikanti L, Singh V. Epidural lysis of adhesions and myeloscopy. Curr Pain Headache Rep 2002; 6:427-435.
29. Manchikanti L, Saini B, Singh V. Spinal endoscopy and lysis of epidural adhesions in the management of chronic low back pain. Pain Physician 2001; 4:240-265.
30. Saberski L, Brull S. Spinal and epidural endoscopy: A historical review. Yale J Bio Med 1995; 68:7-15.
31. West S, King V, Carey T, Lohr K, McKoy N, Sutton S, Lux L. Systems to rate the strength of scientific evidence. Evidence Report/Technology Assessment No. 47 University of North Carolina: Agency for Healthcare Research and Quality. AHRQ Publication No. 02-E016; April 2002
32. van Tulder M, Assendelft W, Koes B, Bouter LM. Method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group for Spinal Disorders. Spine 1997; 22:2323-2330.
33. Shekelle PG, Andersson G, Bombardier C, et al. A brief introduction to the critical reading of the clinical literature. Spine 1994;19(suppl):2028S-2031S.
34. Heavner JE, Racz GB, Raj P. Percutaneous epidural neuroplasty. Prospective evaluation of 0.9% NaCl versus 10% NaCl with or without hyaluronidase. Reg Anesth Pain Med 1999; 24:202-207.
35. Racz GB, Heavner JE, Raj PP. Percutaneous epidural neuroplasty. Prospective one-year follow up. Pain Digest 1999; 9: 97-102.
36. Manchikanti L, Rivera J, Pampati V, Damron KS, MCManus CD, Brandon DE, Wilson SR. One day lumbar epidural adhesiolysis and hypertonic saline neurolysis in treatment of chronic low back pain: A randomized double blind trial. Pain Physician. 2004; 7:177-186.
37. Manchikanti L, Pampati V, Fellows B, Rivera JJ, Beyer CD, Damron KS. Role of one day epidural adhesiolysis in management of chronic low back pain: A randomized clinical trial. Pain Physician 2001; 4:153-166.
38. Manchikanti L, Pakanati R, Bakhit CE, Pampati V. Role of adhesiolysis and hypertonic saline neurolysis in management of low back pain. Evaluation of modification of Racz protocol. Pain Digest 1999; 9:91-96.
39. Manchikanti L, Pampati V, Bakhit CE, Pakanati RR. Non-endoscopic and endoscopic adhesiolysis in post lumbar laminectomy syndrome. A one-year outcome study and cost effective analysis. Pain Physician 1999; 2:52-58.
40. Manchikanti L, Pampati V, Rivera J, Fellows B, Beyer CD, Damron KS, Cash KA. Effectiveness of percutaneous adhesiolysis and hypertonic saline neurolysis in refractory spinal stenosis. Pain Physician 2001; 4:366-373.
41. Racz GB, Holubec JT. Lysis of adhesions in the epidural space. In Racz GB (ed). Techniques of Neurolysis. Kluwer Academic press, Boston, 1989, pp 57-72.
42. Hammer M, Doleys D, Chung O. Transforaminal ventral epidural adhesiolysis. Pain Physician 2001; 4: 273-279.
43. Devulder J, Bogaert L, Castille F, Moerman A, Rolly G. Relevance of epidurography and epidural adhesiolysis in chronic failed back surgery patients. Clin J Pain 1995; 11: 147-150.
44. Arthur J, Racz GB, Heinrich R, Diede JH, McCann M, Wilson E, Heavner J C., Noe C. Epidural space. Identification of filling defects in lysis of adhesions in the treatment of chronic painful conditions. In: Abstracts, 7th World Congress of Pain. Paris, IASP Publications, 1993, pp 557.
45. Manchikanti L, Rivera JJ, Pampati V, Damron KS, Beyer CD, Brandon DE, Wilson SR. Spinal endoscopic adhesiolysis in the management of chronic low back pain: A preliminary report of a randomized, double-blind trial. Pain Physician 2003; 6: 259-268.
46. Manchikanti L, Boswell MV, Rivera JJ, Pampati V, Damron KS, McManus CD, Brandon DE, Wilson SR. A randomized, controlled trial of spinal endoscopic adhesiolysis in chronic refractory low back and lower extremity pain. 2005; in press.
47. Geurts JW, Kallewaard JW, Richardson J, Groen. Targeted methylprednisolone acetate/hyaluronidase/clonidine injection after diagnostic epiduroscopy for chronic sciatica: a prospective, 1-year follow-up study. Reg Anesth Pain Med 2002; 27:343-352.
48. Igarashi T, Hirabayashi Y, Seo N, Saitoh K, Fukuda H, Suzuki H. Lysis of adhesions and epidural injection of steroid/local anesthetic during epiduroscopy potentially alleviate low back and leg pain in elderly patients with lumbar spine stenosis. Br J Anaesth 2004; 93:181-187.
49. Richardson J, McGurgan P, Cheema S, Prasad R, Gupta S. Spinal endoscopy in chronic low back pain with radiculopathy: A prospective case series. Anaesthesia 2001; 56:454-460.
50. Manchikanti L. The value and safety of epidural endoscopic adhesiolysis. Am J Anesthesiol 2000; 275-278.
51. Saberski L. A retrospective analysis of spinal canal endoscopy and laminectomy outcomes data. Pain Physician 2000; 3: 193-196.
52. Lewandowski EM. The efficacy of solutions used in caudal neuroplasty. Pain Digest 1997; 7:323-330.
53. Houten JK, Errico TJ. Paraplegia after lumbosacral nerve root block: Report of three cases. Spine J 2002; 2:70-75.
54. Bromage RP, Benumof JL. Paraplegia following intracord injection during attempted epidural anesthesia under general anesthesia. Reg Anesth Pain Med 1998; 23: 104-107.
55. MacLean CA, Bachman DT. Documented arterial gas embolism after spinal epidural injection. Ann Emerg Med 2001; 38:592-595.
56. Mateo E, Lopez-Alarcon MD, Moliner S, Calabuig E, Vivo M, De Andres J, Grau F. Epidural and subarachnoid pneumocephalus after epidural technique. Eur J Anesthesiol 1999; 16:413-417.
57. Katz JA, Lukin R, Bridenbaugh PO, Gunzenhauser L. Subdural intracranial air: An unusual cause of headache after epidural steroid injection. Anesthesiology 1991; 74: 615.
58. Benzon HT, Wong HY, Siddiqui T, Ondra S. Caution in performing epidural injections in patients on several antiplatelet drugs. Anesthesiology 1999; 91:1558-1559.
59. Mamourian AC, Dickman CA, Drayer BP, Sonntag VK. Spinal epidural abscess: Three cases following spinal epidural injection demonstrated with magnetic resonance imaging. Anesthesiology 1993; 78: 204-207.
60. Knight JW, Cordingley JJ, Palazzo MG. Epidural abscess following epidural steroid and local anesthetic injection. Anaesthesia 1997; 52:576-578.
61. Vijayan N, Dreyfus PM. Chemical epidural abscess: Case report. J Neurol Neurosurg Psychiatry 1971; 34:297-299.
62. Kaul S, Meena AK, Sundaram C, Reddy JM, Naik RT, Murthy JM. Spinal extradural abscess following local steroid injection. Neurol India 2000; 48:181-183.
63. Chan ST, Leung S. Spinal epidural abscess following steroid injection for sciatica: Case report. Spine 1989; 14:106-108.
64. Goucke CR, Graziotti P. Extradural abscess following local anaesthetic and steroid injection for chronic low back pain. Brit J Anesth 1990; 65:427-429.
65. Yamaguchi M, Kawakubo A, Ide R, Hara K, Sumikawa K. Epidural abscess associated with epidural block in a patient with immunosuppressive disease. Jpn J Anesthesiol 1999; 48:506-508.
66. Sabel M, Felsberg J, Neuen-Jacob E, Lichota A, Schnitzler A, Herdmann J. Enlargement of a chronic aseptic lumbar epidural abscess by intraspinal injections - a rare cause of progressive paraparesis. Zentralbl Neurochir 2000; 61:111-114.
67. Gutknecht DR. Chemical meningitis following epidural injections of corticosteroids (Letter). Am J Med 1987; 82:570.
68. Williamson JA. Inadvertent spinal subdural injection during attempted spinal epidural steroid therapy. Anaesth Intens Care 1990; 18:406-408.
69. Lubenow T, Keh-Wong E, Kristof K, Ivankovich O, Ivankovich AD. Inadvertent subdural injection: A complication of an epidural block. Anesth Analg 1988; 67:175-179.
70. Dreskin S, Bajwa ZH, Lehmann L et al. Polymyoclonus resulting from possible accidental subdural injection of local anesthetic. Anesth Analg 1997; 84:692-693.
71. Kim RC, Porter RW, Choi BH, Kim SW. Myelopathy after intrathecal administration of hypertonic saline. Neurosurgery 1988; 22:942-944.
72. Aldrete JA, Zapata JC, Ghaly R. Arachnoiditis following epidural adhesiolysis with hypertonic saline report of two cases. Pain Digest 1996; 6:368-370.
73. Hitchcock ER, Prandini MN. Hypertonic saline in management of intractable pain. Lancet 1973; 1:310-312.
74. Lucas JT, Ducker TB, Perot PL. Adverse reactions to intrathecal saline injections for control of pain. J Neurosurg 1975; 42:57-561.
75. Dagi TF. Comments on myelopathy after the intrathecal administration of hypertonic saline. Neurosurgery 1988; 22:944-945.
76. Lundy JS, Essex HE, Kernohan JW. Experiments with anesthetics. IV. Lesions produced in the spinal cord of dogs by a dose of procaine hydrochloride sufficient to cause permanent and fatal paralysis. JAMA 1936; 101: 1546-1550.
77. Gentili ME, Samii K. Accidental epidural injection of hypertonic sodium chloride solution. Ann Fr Anesth Reanim 1991; 10: 401-403.
78. Manchikanti L, Bakhit CE. Removal of torn Racz catheter from lumbar epidural space. Reg Anesth 1997; 22:579-581.
79. Tabandeh H. Intraocular hemorrhages associated with endoscopic spinal surgery. Am J Ophthalmol 2000; 129:688-690.
80. Hammer M. Safety of spinal endoscopy is contingent on basic image interpretation. Letter to the editor. Reg Anesth Pain Med 2002; 27:621.
81. Kusher FH, Olson JC. Retinal hemorrhage as a consequence of epidural steroid injection. Arch Opthalmol 1995; 113:309-313.
82. Purdy EP, Gurjit SA. Vision loss after lumbar epidural steroid injection. Anesth Analg 1998; 86:119-122.
83. Kao LY. Bilateral serous retinal detachment resembling central serious chorio-retinopathy following epidural steroid injection. Retina 1998; 18:479-481.
84. Sandberg DI, Lavyne MH. Symptomatic spinal epidural lipomatosis after local epidural corticosteroid injections: Case report. Neurosurgery 1999; 45:162-165.
85. Trattner A, Hodak E, David M, Neeman A, Sandbank M. Kaposi's sarcoma with visceral involvement after intraarticular and epidural injections of corticosteroids. J Am Acad Dermatol 1993; 29:890-894.
86. Knight CL, Burnell JC. Systemic side effects of extradural steroids. Anaesthesia 1980; 35:593-594.
87. Jacobs S, Pullan PT, Potter JM, Shenfield GM. Adrenal suppression following extradural steroids. Anaesthesia 1983; 38:953-956.
88. Boonen S, Van Distel G, Westhovens R, Dequeker J. Steroid myopathy induced by epidural triamcinolone injection. Brit J Rheumatol 1995; 34:385-386.
89. Maillefert JF, Aho S, Huguenin MC, Chatard C, Peere T, Marquignon MF, Lucas B, Tavernier C. Systemic effects of epidural dexamethasone injections. Revue du Rhumatisme 1995; 62:429-432.
90. Ward A, Watson J, Wood P, Dunne C, Kerr D. Glucocorticoid epidural for sciatica: Metabolic and endocrine sequelae. Rheumatology 2002; 41:68-71.
91. Manchikanti L, Pampati V, Beyer CD, Damron KS, Cash KA, Moss TL. The effect of neuraxial steroids on weight and bone mass density: A prospective evaluation. Pain Physician 2000; 3:357-366.
92. Milhaud D, Heroum C, Charif M, Saulnier P, Pages M, Blard JM. Dural puncture and corticotherapy as risks factors for cerebral venous sinus thrombosis. Eur J Neruol 2000; 7:123-124.
93. Delaney TJ, Rowlingson JC, Carron H, Butler A. Epidural steroid effects on nerves and meninges. Anesth Analg 1980; 58: 610-614.
94. Mackinnon SE, Hudson AR, Gentili F, Kline DG, Hunter D. Peripheral nerve injection injury with steroid agents. Plast Reconstr Surg 1982; 69:482-489.
95. Chino N, Awad EA, Kottke FJ. Pathology of propylene glycol administered by perineural and intramuscular injection in rats. Arch Phys Med Rehab 1974; 55:33-38.
96. Benzon HT, Gissen AJ, Strichartz GR, Avram MJ, Covino BG. The effect of polyethylene glycol on mammalian nerve impulses. Anesth Analg 1987; 66:553-559.
97. Abram SE, Marsala M, Yaksh TL. Analgesic and neurotoxic effects of intrathecal corticosteroids in rats. Anesthesiology 1994; 81:1198-1205.
98. Latham JM, Fraser RD, Moore RJ, Blumbergs PC, Bogduk N. The pathologic effects of intrathecal betamethasone. Spine 1997; 22:1558-1562.
99. Robustelli della Cuna FS, Mella M, Magistrali G, Ricci M, Losurdo A, Goglio AM. Stability and compatibility of methylprednisolone acetate and ropivacaine hydrochloride in polypropylene syringes for epidural administration. Am J Health Syst Pharm 2001; 58:1753-1756.
100. Slucky AV, Sacks MS, Pallares VS, Malinin TI, Eismont FJ. Effects of epidural steroids on lumbar dura material properties. J Spin Disord 1999; 12:331-340.
101. Manchikanti L. Role of neuraxial steroids in interventional pain management. Pain Physician 2002; 5:182-199.
102. Bogduk N, McGuirk B. Monotherapy. In Bogduk N, McGuirk B (eds). Medical Management of Acute and Chronic Low Back pain. An Evidence-Based Approach: Pain Research and Clinical Management, Vol. 13, Elsevier Science BV, Amsterdam, 2002: 143-161.
103. Fibuch EE. Percutaneous epidural neuroplasty: Cutting edge or potentially harmful pain management? Reg Anesth Pain Med 1999; 24:198-201.