Relations between CT-epidurography and the tip position of Racz catheter during percutaneous epidural adhesiolysis applied for the degenerative lumbar spinal canal stenosis

Abstract

Introduction: Percutaneous epidural adhesiolysis (PEA) is used for lumbar spinal stenosis with suspected epidural adhesions. The Racz catheter method typically guides the tip to the ventral epidural space, but epidurography or radiculography can occur even if the tip is not ventral. This study retrospectively examined the relationship between catheter tip position and epidural imaging in degenerative lumbar spinal stenosis (DLSCS). Methods: We compared catheter tip position with postoperative CT-epidurography in 57 DLSCS cases treated via the sacral hiatus from 2022 to 2023. Results: Of 57 cases, 28 had ventral catheter positioning and 29 dorsal. Epidurography showed no significant differences in ventral, affected-side, affected-level, or nerve root imaging. Conclusion: In DLSCS treatment, effective drug delivery is possible even when the catheter tip is not positioned on the ventral side.