Percutane Neuroplastia and Adhesiolysis

        Percutaneous Neuroplasty and Adhesiolysis (aka removal of adhesions), most commonly known as the Racz procedure, was first introduced by Dr. It was started to be implemented by Gabor Racz. The Racz procedure is applied to remove adhesions due to scar tissue in the epidural area.

       This procedure is most commonly performed on patients with failed back surgery syndrome (FBSS), spinal stenosis, and radiculopathy. It can also be effective in the treatment of painful conditions due to the scarring of herniated discs in the anterior lateral epidural area.

      The epidural area is a thin area between the inside of the spinal column and the protective layers around the spinal cord. There are blood vessels and nerve roots as well as adipose tissue in the epidural region. Scar tissue in the epidural area is not painful on its own. However, it causes neuropathic pain by applying pressure to the nerves located here, by compressing, and by restricting their natural movements.

                                        How to Apply

       A specially designed needle and Racz ® catheter are guided under sedation to the area of ​​scar tissue in the epidural area of ​​the patient with the help of fluoroscopic imaging. After the location of the scar tissue is confirmed with contrast material, a special drug called hyaluronidase is injected and the scar tissue is broken up with the mechanical forces of the Racz catheter. Finally, a mixture of steroids and local anaesthetics is injected to reduce inflammation and relieve pain. Thus, with this procedure, the restrictive scar tissue is broken down and dissolved, and this treats neuropathic pain by releasing the nerve roots.

      In most cases, this procedure can be done on a day-to-day basis and the patient can return home the same day. Patients with an excessive amount of scar tissue may need two to three completed injections. Patients begin basic stretching exercises immediately after the procedure is completed.

      In most patients, recovery will begin within a few days after the procedure. Some patients will experience instant relief; for others it may take several weeks to achieve measurable improvement. Most patients can return to work one day after catheter removal.