Epiduroscopy / adhesiolysis

What is epiduroscopy/adhesiolysis?
Epiduroscopy is a method of directly visualizing and potentially treating pain generators inside of the spinal column.  A small flexible fiberoptic catheter is inserted through a tiny incision and the areas of concern can be visualized on a video monitor.  Medication can then be injected through the same catheter.

What are the main uses of epiduroscopy/adhesiolysis?
Adhesions, or scar tissue, that may be pulling on or irritating specific nerve roots can sometimes be effectively stretched or loosened using this device.  By so doing, steroids injected through the catheter can be more effective.

Who benefits from epiduroscopy/adhesiolysis?
Anyone with low back pain or sciatic and a history of an inflamed disc or prior surgery can potentially benefit.

6. Annuloplasty/IDET

What is an annuloplasty/IDET procedure?
Annuloplasty/IDET is a percutaneous (through the skin) technique requiring only a puncture site.  A special thermal wire probe is inserted into the disc under fluoroscopic control. The probe heats the inside of the disc for approximately 15 minutes. As this occurs, it is believed that the painful micro-fissures in the outer portion (annulus) of the disc seal over and the tiny sensory nerve endings that supply the disc are desensitized. In addition, over the next three months, the collagen bonds in the annulus tighten and the disc is ultimately remodeled into a more stable, less painful form.

Who benefits from this procedure?
IDET is commonly used for low back pain secondary to degenerative disc disease, but only after a discogram has validated the disc as the source of pain. This procedure reliably reduces pain in a select group of patients without undergoing a high-risk open operation, such as lumbar fusion.  The procedure is done on an outpatient basis and of low risk.

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