What is Epiduroscopy?
Epiduroscopy is a relatively new procedure aimed at directly examining the contents of the epidural space The area of the spinal canal between the dural sac which contains fluid and the spinal cord and the bones. using a fibreoptic scope through the sacro-coccygeal membrane The very bottom of the spine, near the coccyx where the epiduroscope can be introduced. .
Who might benefit?
- Patients with sciatica which is unexplained.
- Patients with sciatica Pain down the leg in a distribution which suggests it is due to inflammation or irritation of a nerve. persisting after surgery to correct disc protrusions or spinal stenosis.
- Patients with scar tissue or adhesions Scar tissue. around nerve roots.
- Patients with inflammation or suspected inflammation in the spinal canal.
Is it painful?
Epiduroscopy should not be a painful procedure if performed in an appropriate setting. The module Anaesthetic considerations has been formulated by a specialist anaesthetist outlining the medication used to minimise pain and maximise cooperation.
What are the advantages?
Epiduroscopy allows direct visualization of the contents of the epidural space The area of the spinal canal between the dural sac which contains fluid and the spinal cord and the bones. . Nerve roots The beginning of the nerves which eventually form the sciatic nerve down the leg. and adhesions Scar tissue around them can be seen and in some cases broken down releasing the nerve. Structures can be stimulated and the response correlated with a patient's pain. Focal inflammation can be identified and bathed in topical steroid solutions.
What are the side-effects and complications?
Like all spinal interventional procedures side-effects and complications can occur.
Common side-effects are:
- Sore coccyx
- Redness around coccyx
- Slight ooze around coccyx
- Some increase in pain for a few days or a week
- Infection around the spine
- Significant bleeding around the spine
- Neurological loss (weakness or numbness which persists)
- Blindness
Epiduroscopy involves passing a small fibreoptic scope into the epidural space and observing the presence of scar tissue, fat, nerves etc.