Epidural fibrosis is the excessive production of scar tissue, found near the root of a nerve. It is common to see it after spinal surgery. Epidural fibrosis develops as scar tissue attaches to the nerve root during the months after surgery..
Postoperative significant epidural fibrosis and aracnoiditis adhesive, are the most common causes of failed back surgery syndrome after spinal surgery. Although the latest research shows that so much can happen in successful back surgeries, as in failed.
The risk of developing epidural fibrosis is higher in patients with more complicated back surgeries
Upon completion of back surgery, the last thing you're anticipating is another problem. Unfortunately, most surgeries carry the risk of complications, from causing pain, including other postoperative symptoms, including scarring at the surgery site.
Index
Diagnostico
The diagnosis of epidural fibrosis can easily be confused with arachnoiditis. Nevertheless, epidural fibrosis affects the outermost layer of the spinal cord (the dura), while arachnoiditis goes to a deeper layer in the arachnoid membrane.
Your doctor may order an MRI or CT scan to diagnose any epidural fibrosis you may have.. Many times, scarring cannot be seen with this type of imaging test.
The problem is that, many times, you have the symptoms, but the MRI is negative. In this case, an epiduroscopy is needed (introduction of an optical fiber through a steerable catheter).
In the epiduroscopy test an endoscope is inserted into the affected area, so that the surgeon can directly observe what is happening at the nerve root. A) Yes, the specialist can determine if the origin of the pain is due to fibrosis or due to a herniated disc.
Causes of epidural fibrosis
Epidural fibrosis is caused as a result of back surgery. Inflammation may be the cause of scar tissue formation, and this can lead to agglutination of the spinal nerves, a very painful and difficult to treat condition.
Then, when the spinal surgeon doctor works in the vicinity of the nerve root area (excising fragments or bone spurs), is creating wounds directly in the area. And for any wound, scarring is the body's natural response.
The development of epidural fibrosis can be compared to the scab that forms on the skin after an injury.. Scab and epidural fibrosis are natural healing processes. Epidural scarring occurs between the 6 and 12 weeks after surgery.
Symptoms of epidural fibrosis
The signs of the presence of an epidural fibrosis is pain that varies from moderate to severe in the area of the back, which may increase in the weeks or months following surgery. Although statistics reveal that only the 20 percent of patients actually get worse.
Treatment for epidural fibrosis
Controlling pain and inflammation are the main goals for treatment for epidural fibrosis.. Physical therapy may be considered to maintain movement. Keeping your joints in constant motion can help limit scar tissue formation. Specifically, strengthening exercises should be performed, stretching and core exercises.
Spinal endoscopy is another treatment your doctor may suggest. AND, as we explained previously, a fiber optic is inserted that allows your doctor to visualize the area. If the scars are within the reach of a laser, you can choose this method.
Surgery to remove excess scar tissue around the nerve root is not recommended. This is because a new operation on the scar can produce more scars.. One study reports that, usually, this new intervention only has a success rate of 30 al 35 percent.
Although surgery is not recommended for epidural fibrosis, there are surgical treatments that are percutaneous adhesiolysis and spinal endoscopy.
Percutaneous adhesiolysis is applied, not just epidural fibrosis, It is also used for other causes of failed back surgery syndrome. Steroid medications are often injected in the procedure, through a catheter inserted into the affected area. Mechanical rupture of scars markedly reduces symptoms.