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Decompression Neuroplasty or Caudal Epidural

AnonymousUserAAnonymousUser Posts: 49,321
edited 06/11/2012 - 8:36 AM in Lower Back Pain
What is the difference between a decompression neuroplasty & a lumbar steriod epidural? What are the pros and cons of each?


  • Would you be able to provide more details about your condition and explain in what context the doctor mentioned those two terms?

    Thanks, Val
  • Thank you for asking this question. I was not familiar with neuroplasty, and learned about it as a result.

    Basically a epidural steroid injection is given for a variety of reasons. It is a direct method of delivering a steroid to the area where it is injected...a nerve root, facet joint, etc. bypassing the rest of the body. It often is given to reduce inflammation.

    Neuroplasty is done to repair nerve damage. It is a procedure that is used to break up scar tissue that has formed around the nerve in the epidural space of the spine, so medications such as the steroid can reach the affected nerve/nerves so pain and other symptoms will lessen or go away. The actual procedure is similar to a caudal steroid injection in that a thin catheter is inserted from very low in the spine and it runs up to the point where there is scarring.

    If this were a caudal injection, the medicine would be injected after the placement of the catheter...and the procedure would be finished. Apparently in neuroplasty, or the "Racz procedure" the catheter is left in place as a series of injections must be done in subsequent days. I do not know if it is only done in an attempt to break up scar tissue or if there are other reasons.

    The neuroplasty is similar to an "ESI" but is more complex. ESIs are given for a variety of reasons -- it is just a way of delivering a steroid medication directly to a particular area.

    I hope this helps. Tons of people on the board have had ESIs. I don't know of anyone who has had the neuroplasty. It certainly is not a standard treatment, whereas ESI is just about the first procedure that is tried when one first develops back or spine problems.

    Have these procedures been recommended to you?

    xx Gwennie
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  • maureen kmmaureen k Posts: 1
    edited 03/22/2015 - 9:47 AM
    yes this was done but did not relieve my pain. after many epidural injections for two years, much physical therapy, i am still in intense pain every day and unable to walk more than a couple blocks without severe pain. so now i am heading to an orthopedic surgeon to see what can be done about this pinched nerve in my back. i have bulging discs, arthritis, sciatica, scoliosis pretty severe and loss of disc cushion in one area so there are multiple problems. i have had some pain most days since i was 30 yrs old due to a car accident that aggravated my scoliosis and sciatica but i have remained very active and kept my weight under control and it has been manageable until recent couple of years and another car accident in which i was a passenger and we were struck by a speeding driver at an intersection on my side of the car. since that time my back pain has gradually become unbearable. i am now 64 yrs old and so aging combined with this latest accident has caused this increase in pain.

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