RACZ Caudal Neurolysis

What is the RACZ Catheter Procedure?

The RACZ catheter procedure, also known as epidural neurolysis, is designed to relieve pain caused by scar tissue wrapped around nerves in the spinal epidural space. By removing some of this scar tissue, the procedure facilitates the delivery of drugs, such as cortisone, to the affected areas, reducing pain.

How the RACZ Caudal Neurolysis Works

The physician locates the small opening at the base of the sacrum (called the sacral hiatus) and injects a local anesthetic that numbs the skin and all the tissue down to the surface of the sacral hiatus. The physician then guides the needle through the anesthetized track and into the epidural space. A contrast solution is injected, allowing the physician to see the scarred and painful areas on an X-ray device called a fluoroscope.

A small, flexible catheter is fed through the needle and positioned at the location of the scarring. A steroid-anesthetics mix is injected through the catheter and around the scarring, bathing the painful area in medication and dissolving the scar tissue.

The needle and catheter are removed. In some cases, it may be necessary to keep the catheter in place to allow for more injections over the next few days. It also may be necessary to repeat the procedure a few months later to reduce scar tissue further.

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Amr Hosny, MD, MBA, FASABook Now David Chu, MD, FAAPMRBook Now Vivek Mehta, MD, FAAPMRBook Now Deepali Gupta, MD, DABA, DABPMBook Now

Are There Any Risks With RACZ Caudal Neurolysis?

While this is generally considered a very safe procedure, it is important to remember that, as with any medical procedure, there are risks and possible side effects.

Complications resulting from selective nerve root blocks and epidural steroid injections can include:

• Pain at the injection site – common
• Temporary worsening of symptoms – observed occasionally
• Infection – rare
• Bleeding – also rare
• Severe nerve or spinal cord damage – extremely rare

Other side effects are often related to the steroid drug itself and may include:

• Fluid retention – rarely reported
• Weight gain – rarely reported
• Increased blood pressure – also rare

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