Percutaneous Adhesiolysis


A major cause of disability worldwide, lower back pain is often accompanied by radicular pain. The most common cause of lumbar radicular pain is lumbar disc herniation, which is also the major cause of lower back pain. Although most patients with lower back pain and radicular pain improve within 12 weeks, between 6-11% of patients experience chronic lower back pain.

Percutaneous adhesiolysis is used to relieve pain and increase functional capacity in patients suffering from chronic lower back pain – with or without radiculopathy – that persists even after conservative treatment and injections.

The procedure is performed to disrupt epidural adhesions, which affect the nerves and other pain-sensitive tissues. Percutaneous lysis of epidural adhesions also improves the delivery of injected drugs to the target area. In the scientific literature, there is substantial evidence of the short-term (<3 months) efficacy of percutaneous adhesiolysis and moderate evidence of its mid- to long-term (>3 months) efficacy.


Percutaneous adhesiolysis is used to treat patients with chronic lower back pain that does not respond well to conservative methods, such as physical therapy, and injections.

Indications for percutaneous adhesiolysis include the following:

  • Post-laminectomy syndrome

  • Epidural adhesions

  • Vertebral body compression fractures

  • Disc disruption

  • Radiculopathy

  • Resistant multilevel degenerative arthritis