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Epiduroplasty

An Epiduroplasty is a minimally invasive procedure designed to diagnose and treat chronic back pain. It involves inserting a catheter (a soft hollow tube) with a camera into your spine so your doctor can see the nerves and tissues and diagnose the cause of your back pain.

Also known as: an epiduroscopy, epidural endoscopy or Racz procedure. This involves inserting a small tube (catheter) equipped with a camera into the spine, and with the additional help of x-ray imaging, inserting anti-inflammatory medication into the epidural space. This innovative technique helps relieve back pain.

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Everything you need to know

Epiduroplasty is a minimally invasive procedure designed to diagnose and treat chronic back pain. It involves inserting a catheter (a soft hollow tube) with a camera into your spine so your doctor can see the nerves and tissues and diagnose the cause of your back pain. With the help of real-time X-ray vision, your specialist can then inject medication to dissolve any scar tissue around the nerves. By removing this tissue, pressure on the nerves is alleviated and painkillers can also reach the nerves more easily.

An Epiduroplasty is often performed on an outpatient basis, which means you can be treated and go home the same day. It is typically done when more conservative treatments, such as physiotherapy, have not provided sufficient pain relief. The goal of an epiduroplasty is to reduce your pain and so improve your quality of life, by reducing the pressure on the spinal nerves, and delivering pain relief directly to the affected area of your spine.

Before the procedure

You must stop eating at least six hours before your procedure and stop drinking (including water) two hours before.

On the day, it’s a good idea to wear loose, comfortable clothing. You should also arrange for someone to collect you afterwards, as you won’t be able to drive.

Once you have arrived and are settled in your room, a nurse will help prepare you for your procedure by monitoring your vital signs, including blood pressure, body temperature and weight, and will also run through your medical history, medications and emergency contacts.

Your doctor will then check in on you, run you through the procedure once again and ask you to sign a consent form that confirms you are happy to go ahead.

During the procedure

For this procedure, you will need to come to our imaging department as it will be performed using real time x-ray imaging. We will ask you to lie on your front and then, to make sure the catheter and camera are placed in the right area of your back, a small current will be applied. This will create a tingling sensation in the area that needs treating. Once the correct area has been identified, your doctor will then inject local anaesthetic to numb this area of your back and a catheter will be placed in the epidural space of your spinal canal.

During an epiduroplasty, fluoroscopy (real-time X-ray guidance) is used for precise placement. Medications, such as anaesthetic and anti-inflammatory steroids, may be injected to reduce inflammation and provide pain relief. Additionally, the procedure may involve the use of specialised tools or techniques to break up adhesions or scar tissue that are compressing the nerves and causing pain.

After the procedure, you will be placed on your back, and your legs may feel heavy and/or numb. The anaesthesia should wear off in a few hours. We will also give you some antibiotics to take over the following days to help prevent any infections.

After the procedure

Following the procedure, we will take you to a private room to recover and to have some food. Our nurses will monitor your vital signs, and if you are recovering well, once you have eaten you can go home. You will need someone to collect you from the hospital and take you home, as you will not be able to drive.

Your pain relief may not be instant and once the anaesthetic has worn off, you may feel some soreness in the treated area.

However, with rest and gentle exercises, this should pass within a few days.

Within one month, you should notice a reduction in your pain. By three months, most people find their pain has gone entirely and their mobility has improved.

 

How to pay for your treatment

If you’re… paying for yourself

Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.

For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.

If you’re… insured

St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.