Epidural Lysis of Adhesions

The Racz Procedure — fluoroscopy-guided disruption of epidural scar tissue for patients with epidural fibrosis and failed back surgery syndrome who have not responded to conventional treatments.

Understanding Epidural Adhesions

Following spinal surgery, injury, or chronic inflammation, fibrous scar tissue (adhesions) can form in the epidural space — encasing and compressing nerve roots, restricting cerebrospinal fluid circulation, and creating barriers that prevent medications from reaching target tissues. This condition, known as epidural fibrosis, is a leading cause of persistent pain after spinal surgery (failed back surgery syndrome).

The Racz Procedure, developed by Dr. Gabor Racz, uses a flexible, spring-tip catheter advanced under fluoroscopic guidance to mechanically disrupt adhesions and deliver hypertonic saline, corticosteroid, and hyaluronidase directly to the scarred area, restoring access to compressed neural structures.

Conditions Treated

• Failed back surgery syndrome (FBSS)
• Post-laminectomy syndrome
• Epidural fibrosis following disc surgery
• Chronic radiculopathy unresponsive to ESI
• Spinal stenosis with adhesive component

What Is Delivered

• Hyaluronidase — enzymatic breakdown of adhesive tissue
• Hypertonic saline — reduces perineural edema
• Corticosteroid — anti-inflammatory effect at nerve root
• Local anesthetic — immediate pain relief and diagnostic