European Journal of Molecular & Clinical Medicine

Abstract

          Patients with chronic low back pain (with or without radicular pain) may have peri-neural adhesions from mechanical or chemical irritation while they don't have a history of surgery. This might be the source of chronic low back pain. It is now well accepted that those adhesion are attributed to pain associated with patient's motion. When adhesions persist for a long time, they may cause aggravation of neuritis, demylination, a nerve conduction disorders, ectopic neural transmission and neuropathic pain. Conventional neuroplasty may be divided into either chemical or mechanical adhesionolysis using either epiduroscopy or catheter. Chemical neuroplasty have relatively low effect and a high risk for relapse either due to adhesions themselves (which are difficult to remove) or their interference with effective spread of a therapeutic agents to the lesion.Mechanical adhesionolysis has the theoretical advantage that the adhered region around the nerve is separated either with epiduroscopy or directly with a catheter. We used direct dilatation using Seldinger's method and dilator provided in central venous line set (BALATON®) to enable relief of spinal stenosis by expanding the space around the nerve in the stenotic intervertebral foramen and injecting steroids with (HYALASE) in the area.