Precautions during epidural neuroplasty

Abstract

Scar formation in the epidural space due to previous operations or presence of inflammation in and around the nerve roots or spinal nerves in patients with back pain or radiculopathy have been documented in patients suffering from spinal pain. Several methods targeting the scar formation and inflammation have been used. Epidural neuroplasty is one of the recently used methods. The goals of neuroplasty are to break down fibrous adhesions that may prevent free movement of structures in the intervertebral foramen and in the bony vertebral canal. However, epidural neuroplasty is not free of complications. During epidural neuroplasty, unintended dural puncture, administration of hypertonic saline to the subarachnoid/subdural space, catheter shear, infection, and haemodynamic instability during the application are the most commonly observed complications. The most commonly seen complications of epidural neuroplasty are due to the procedure or the drugs administered. Complications relating to the procedure are usually seen immediately, while complications relating to drug administration are typically seen later. In this article, we discuss not only the possible complications during epidural neuroplasty, but their prevention and management as well.