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Spinal Pain Following Discectomy

If you've had a discectomy and are still suffering from spinal pain, your doctor may have mentioned a condition known as epidural fibrosis.  If that's you and you are wondering just what it all means, read on for more information.

What Is Epidural Fibrosis? 

Epidural fibrosis is the name given to the scarring that takes place at the site of surgery on back. It can entrap nerves and cause pain. Most patients will develop some scar tissue following successful back surgery and will have no pain or negative symptoms. However, this is not the case for all. Epidural fibrosis falls under the category of Failed Back Surgery Syndrome, also known as FBSS. It should be known that doctors and researchers are at odds as to whether scar tissue may be the cause of spinal pain following surgery—some believe the two are linked, while others believe they are not. 

What Causes It?

Whenever a person experiences a wound, whether accidental or deliberate, scarring is the body's natural response. In fact, the development of epidural fibrosis following spinal surgery is comparable to a scab that forms on your body following a scrape or cut—it is part of your body's natural healing process.

How Is Epidural Fibrosis Diagnosed?

Epidural fibrosis is usually diagnosed using MRI scanning. However, in some instances, an MRI cannot pick up the scar tissue. In cases where a scan shows nothing, but the spinal pain is still there, a surgeon may suggest an exploratory test. This will usually be an epiduroscopy. The surgeon will insert a probe or scope into the area to take a close look at the nerve root to see if it's being troubled by scar tissue. An epiduroscopy will also identify whether the spinal pain is due to the herniation of another disc, rather than scar tissue. Surgery may be required if a herniation is found. Surgery is rarely performed for epidural fibrosis, as there is no guarantee that further cutting will cure the problem and not cause even more scarring.

What Is the Treatment Protocol for Spinal Pain Caused by Epidural Fibrosis?

Doctors have differing views about what works best as a treatment for this condition. Therefore, treatment will depend on the individual doctor and their beliefs. Often the best form of treatment will be medication to relieve pain and physiotherapy to keep you strong and mobile. 

If a different treatment plan is considered, it's likely to be either percutaneous adhesiolysis or spinal endoscopy. Percutaneous adhesiolysis involves medicines being inserted into the area via a catheter, while spinal endoscopy will usually involve scope insertion into the area and possibly laser treatments on the scar tissue. Percutaneous adhesiolysis currently has the best outcome and, as such, is usually the preferred choice.