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An adhesion is a band of scar tissue that binds two parts of body tissue that are not usually joined together. Pain typically results from an adhesion because of restricted movement, pressure on a nerve, or an obstruction.

Adhesiolysis is the procedure that breaks up the scar tissue, thus relieving the pain.

What Is Adhesiolysis?

Adhesiolysis is a minimally-invasive surgical procedure that breaks up adhesions and treats the affected area with steroids and other medications. The process is considered both safe and effective in dissolving scar tissue.

Causes of Adhesions

An adhesion can form during the body’s healing process after tissue disturbance. This can be from surgery, infection, trauma, or even radiation.

It’s common for patients suffering from back pain caused by scar tissue to have previously undergone back surgery because scar tissue can aggravate nearby nerve roots, causing intense pain that can radiate to the buttocks, legs, and feet.

How Is Adhesiolysis Performed?

While under mild sedation, adhesiolysis is performed with an X-ray to view the spine. Contrast dye is injected into the area to see the area affected by scar tissue buildup.

If nerve root inflammation is the source of a patient’s pain, a needle is placed into the lower back, and a steroid is injected to relieve the pain.
If scar tissue is responsible for the pain, a catheter is inserted, and medication is injected to destroy the scar tissue, reducing inflammation and pain. A balloon can be inserted if needed to help create more room around the compressed nerve. And sometimes, pulsed radiofrequency is used to encourage nerve regeneration if needed.

Although a needle is used with this procedure, it is essential to note that it is not inserted into the spine. Instead, it is placed in the posterior of the back, improving medication distribution to the affected regions.

What Conditions Are Treated with Adhesiolysis?

There are different spine and back conditions that adhesiolysis is beneficial in treating, including:

  • Spinal surgery syndrome.
  • Spinal stenosis.
  • Lumbar and cervical pain.
  • Leg pain.

Spinal surgery syndrome can occur after spinal surgery when pressure on spinal nerves from scar tissue causes chronic pain in the lumbar region of the spine (lower back). The first line of treatment is usually an injection of steroids. However, adhesiolysis often provides more effective and longer-lasting pain relief. While steroid injections may help to reduce inflammation, they do not dissolve scar tissue.

Spinal stenosis is a spinal canal narrowing that compresses the nerves, causing pain, muscle weakness, and motor problems. Both scar tissue and inflammation of the spinal nerves may cause these symptoms. Following adhesiolysis, patients typically report less back pain, while some patients report no pain.

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Dr. Aneeta Talwar, Best Gynaecologist and Obestrician in Bangalore

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