BACKGROUND Chronic persistent low back and lower extremity pain secondary to central spinal stenosis is common and disabling. Lumbar surgical interventions with decompression or fusion are most commonly performed to manage severe spinal stenosis. However, epidural injections are also frequently performed in managing central spinal stenosis. After failure of epidural steroid injections, the next...

BACKGROUND Lumbar surgery and epidural injections for spinal stenosis are the most commonly performed interventions in the United States. However, there is only moderate evidence to the effectiveness of surgery and caudal epidural injections. The next sequential step is adhesiolysis and hypertonic neurolysis with targeted delivery. There have not been any randomized trials evaluating the effect...

BACKGROUND Cervical central stenosis (CCS) is a narrowing of the spinal canal that can cause mechanical compression of the spinal nerve and roots, leading to neck pain and/or radicular pain. Cervical epidural steroid injections are commonly used in the treatment of CCS. After failure of epidural steroid injections, the next sequential step is percutaneous adhesiolysis with a targeted drug deliv...

BACKGROUND Speculated causes of post lumbar surgery syndrome include epidural fibrosis, acquired stenosis, and facet joint pain among other causes. Even though fluoroscopically directed caudal epidural injections and facet joint interventions are effective in some patients, others continue to suffer with chronic persistent pain. Percutaneous adhesiolysis with target delivery of medications has ...

results at three days, one month, three months, and six months after pea compared to pre-pea evaluations, the pain scores and medication intake were significantly decreased. significant pain relief declined from 95% at three days to 75% at six months. conclusions pea for low back pain due to contained disc herniation is a safe and effective procedure. therefore, it may be considered as an optio...

OBJECTIVE We assessed a unique technique of laparoscopic peritoneal dialysis (PD) catheter insertion which can minimize catheter dysfunction. METHODS We performed a retrospective review of patients undergoing laparoscopic PD catheter placement with a Quinton percutaneous insertion kit between July 2000 and December 2004. RESULTS Thirty-one catheters were placed laparoscopically. The mean op...

BACKGROUND Post lumbar surgery syndrome or failed back surgery syndrome with persistent pain continues to increase over the years. The speculated causes of post lumbar laminectomy syndrome include acquired stenosis, epidural fibrosis, arachnoiditis, radiculopathy, and recurrent disc herniation. Epidural fibrosis may account for as much as 20% to 36% of all cases of failed back surgery syndrome....