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Articles: Health, Medicine & Pharmacy

 

How It Works: Epiduroscopy

Epiduroscopy stands for three-dimensional color scanning of the anatomical structure of the structures of the epidural space. This minimally invasive investigation is carried out through the help of a tiny tube with a camera on its end, which does not cause any damage to the body and helps to inspect the shell of nerve fibers, blood vessels, ligaments, fat tissue, intervertebral discs, nerve roots, dura; detect scarring, inflammation pinching, injuries, tumor, can enter the catheter and to establish a pointed drug application.



Epiduroscopy can be applied as a part of diagnostic and therapeutic procedures. Epiduroscopy is valued for an extensive range of benefits: secure access, epidural diagnosis, minimal anesthesia, the exact placement of catheters and electrodes, bypassing the anatomical barriers, removal of scar tissue, speeding up the process of implantation, digital documentation and many more.

Epiduroscopy indications for use

Indications imply conducting diagnosis of back pain of unknown origin and post-operative pain (biopsy is still an option here). During epiduroscopy a removal of postoperative scarring and adhesions, placement systems catheterization, targeted drug administration, implantation of SCS (Spinal Cord Stimulation) electrodes (also known as neuromodulation) is possible. Electrical stimulation of the spinal cord is shown under expressed pain syndrome with phantom pain, causalgia, and peripheral neuropathy, spinal arachnoiditis as a kind of antinociceptive system ‘replacement’.

SCS is a device that represents a source of pulses epidural-seated electrodes and conductors. Targeted administration of drugs (narcotic analgesics, steroid anti-inflammatory drugs) inhibits the conduct of pain impulses along C-fiber nerves. Catheterization provides long-term neurochemical palliative therapy for cancer.

Contraindications

The list of contraindications for local anesthesia (skin infections in the area of a cut), hemorrhagic diathesis, anticoagulant therapy, exacerbation of intercurrent illness, flu-like conditions, high cardio-vascular risks, OPVI, etc.

Preparing for epiduroscopy

Before the study is conducted (apart from general blood test and sugar tests), clinical and functional examination is carried out - spondylography, computer and (or) MRI - magnetic resonance imaging and blood coagulation test are obligatory preparatory measures. If the patient is taking drugs of blood thinning type, one must inform the treating doctor.

Conducting epiduroscopy

A study is carried out in the operating room under sterile conditions by trained personnel. Local anesthesia with simultaneous intravenous administration of opiates is taken advantage of. Anesthesia and low dose examination can be performed in cases where general anesthesia is contraindicated (severe condition, old age, etc.).

In the patient lying on his back a small incision in the sacral holes injected into the epidural endoscope. The patient may feel slight pressure. Under the full control of X-ray apparatus endoscope is pushed to the test site. To improve visibility water is continuously injected.

Epiduroscopy has multiple channels - the main optics and water. Flexible epiduroscopy has an outer diameter of 2.8 mm, the angle of 120? and 170? and a working diameter of 1.2 mm. The monitor reflects clear contrast image of everything that happens in the spinal canal can take photos to document all the changes and progress of the operation. Contrast agents may be used.

Epiduroscopy device

Adhesions are removed by mechanical means - cold laser or forceps. An introduction of anti-inflammatory agents, hemostasis, tissue sampling for histological examination is possible.

After epiduroscopy

Once the study is accomplished, the patient is recommended to have a rest within 2-3 hours. The patient may experience pain at the incision, headache and weakness in the legs. The risk of intervention is stipulated on the eve of the operation, taking into account the individual circumstances of the patient. The result of endoscopy in patient receives the digital carrier - ROM.

Hospital stay equals 3 days. On the day of surgery and the next three days to prevent infection antibiotics are typically appointed. Sutures are removed on the 7th day. Within several weeks it is necessary to restrict the physical load. Other limitations relate to the detection of the disease and are discussed individually.

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