Epidural fibrosis causes chronic back pain and sciatic nerve problems after lumbar spine surgery. Physical therapy and medication provide little relief, and treatment aims to reduce pain levels. Antioxidants like vitamin E may be helpful, but no effective long-term treatment exists. Only 10% of back surgeries result in postoperative back pain, and a proper diagnosis is crucial to differentiate between epidural fibrosis and other conditions.
Epidural fibrosis is one of the most common causes of failed lumbar spine surgery and back surgery syndrome. Symptoms include moderate to severe back pain, including sciatic nerve problems, with no discernible hernia or other medical cause. An effective treatment to cure the condition has been elusive. Treatment aims to reduce pain levels.
The pain triggered by epidural fibrosis is significant and can progress enough over time to become disabling. The pain is chronic and typically does not respond to standard back pain treatments. Physical therapy and prescribed medications provide little or no relief for the condition. Movement aggravates the condition, leading patients to reduce daily activities. In some cases, the patient becomes completely bedridden.
The type of surgery patients require sets the stage for their risk of developing epidural fibrosis. 14 to 1 percent of patients who undergo surgery for a prolapsed intervertebral disc will continue to have back pain after surgery, which can lead to a diagnosis of this condition. Only two to two percent of patients undergoing discectomy develop the condition.
No effective long-term treatment for epidural fibrosis has been developed. The treatment protocol aims at pain relief if complete relief cannot be achieved. Research has shown a measure of success with antioxidants, particularly vitamin E. Narcotic pain medications typically don’t provide complete relief; however, they are sometimes helpful in reducing the severity of the pain.
The development of scar tissue in postoperative back surgery patients has been shown to be insignificant for the development of epidural fibrosis. Many patients develop scar tissue along the nerve roots after surgery and never develop the condition. An exception is when scar tissue binds around the nerve root at the lumbar level and also develops fibrous lesions. Overall, 90% of back surgeries are successful, with 10% developing postoperative back pain.
In most cases of epidural fibrosis, the patient enjoys six to 12 weeks of post-operative pain relief before the problem starts. It begins with slowly developing pain in the leg or back. Continuing pain three months postoperatively indicates that fibrosis may be present, and if so, the pain is likely to increase in intensity and become chronic. In other cases, the pain is caused by an original misdiagnosis of the back injury. A condition called arachnoiditis is often mistaken for epidural fibrosis, making it important to get a proper diagnosis and treatment plan.
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