Epidural adhesiolysis is recommended for radiculopathy due to epidural adhesion following a back surgery. A Racz epidural catheter inserted through an R-K needle is used as a standard tool in this procedure. However, the catheter has a possible drawback that it needs multiple repeated passages through the needle to get an effective adhesiolysis. The authors used a Fogarty balloon catheter instead of a Racz catheter through an R-K needle to improve the lysis in two cases with radiculopathy after previous back surgery. Following a Fogarty catheter was advanced past the adhesive lesion, its balloon was inflated with a radiopaque dye, and then the inflated balloon catheter was pulled back below the adhesive lesion under fluoroscopic visualization. Several trials with this balloon catheter could be achieved effective lysis on epidurogram. Clinical outcomes were a long-term pain relief in one case and short-term relief in the other. These experiences suggest that technical innovation of Racz catheter may improve adhesiolysis. A balloon equipped Racz catheter, a new double lumen balloon catheter containing advantages of Racz and Fogarty catheters, should be made available to improve the quality of epidural adhesiolysis.

KeywordsEpidural adhesiolysis, Racz catheter, Fogarty balloon catheter, Balloon equipped Racz catheter, Failed back surgery syndrome