Caudal Adhesiolysis is a method of epidural injection that can alleviate pain by breaking up scar tissue and freeing entrapped nerves.
This procedure involves accessing the spinal canal through the sacral hiatus (a triangular bone made up of five fused vertebrae forming the posterior section of the pelvis) using a needle. Once the needle tip is confirmed to be in the caudal space utilizing radio-opaque dye, a catheter is inserted and directed under fluoroscopy.
The dye is also used to identify “filling defects,” which indicate the presence of epidural adhesions.
Medications such as hypertonic saline, local anesthetic, and/or steroid are injected during the procedure to treat pain from epidural adhesions, which have been shown to be a cause of lower back pain.
The insertion of the catheter may also create a mechanical disruption of the adhesions, helping to reduce pain. Caudal Adhesiolysis can also be performed with a small scope in place of the catheter, which may aid in the detection of epidural adhesions.