{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:58:53Z","timestamp":1785499133451,"version":"3.56.0"},"reference-count":17,"publisher":"Akademiai Kiado Zrt.","issue":"6","license":[{"start":{"date-parts":[[2025,2,9]],"date-time":"2025-02-09T00:00:00Z","timestamp":1739059200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Epimed International, Inc."},{"name":"PainCare Technologies"}],"content-domain":{"domain":["www.akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2025,2,9]]},"abstract":"\n Epiduralis adhaesi\u00f3k kialakul\u00e1s\u00e1hoz vezethetnek a gerinccsatorna k\u00f6r\u00fcli\n gyullad\u00e1sok, a discusdegenerati\u00f3k (a discus s\u00e9r\u00fcl\u00e9se k\u00f6vetkezt\u00e9ben az epiduralis\n t\u00e9rbe ker\u00fcl\u0151 nucleus pulposus), illetve a gerincm\u0171t\u00e9tek ut\u00e1ni hegesed\u00e9s. Az\n adhaesi\u00f3k k\u00f6vetkezt\u00e9ben a letapadt, mozg\u00e1sban akad\u00e1lyozott gy\u00f6k\u00f6k, illetve a\n gazdagon innerv\u00e1lt ligamentum longitudinale posterius \u00e9s a dura mater egym\u00e1son\n val\u00f3 \u201ecs\u00fasz\u00e1sa\u201d g\u00e1tolt. Ezekn\u00e9l a betegekn\u00e9l kr\u00f3nikus gy\u00f6ki, illetve der\u00e9kt\u00e1ji\n f\u00e1jdalom alakul ki. A konzervat\u00edv kezel\u00e9s lehet\u0151s\u00e9gei igen sokszor limit\u00e1ltak, a\n betegek \u00e9letmin\u0151s\u00e9g\u00e9t az er\u0151s f\u00e1jdalom \u00e9s a neurol\u00f3giai deficit korl\u00e1tozza.\n C\u00e9lunk egy k\u00f6lts\u00e9ghat\u00e9kony, hossz\u00fa t\u00e1von megold\u00e1st jelent\u0151, minim\u00e1linvaz\u00edv\n ter\u00e1pi\u00e1s lehet\u0151s\u00e9g hazai ismertet\u00e9se az \u00e1llami k\u00f3rh\u00e1zakban a fentebb eml\u00edtett\n k\u00f3r\u00e1llapotok kezel\u00e9s\u00e9re. K\u00f6zlem\u00e9ny\u00fcnkben a r\u00e9gi-\u00faj ter\u00e1pi\u00e1s lehet\u0151s\u00e9get, az\n epidurolysist mutatjuk be, mely hat\u00e9konyan alkalmazhat\u00f3 t\u00f6bbek k\u00f6z\u00f6tt az\n epiduralis adhaesi\u00f3k kezel\u00e9s\u00e9ben. A 71 \u00e9ves n\u0151beteg 2019-ben\n L\n IV\u2013V<\/jats:sub>\n -flavotomi\u00e1n \u00e9s discectomi\u00e1n esett \u00e1t, ezt k\u00f6vet\u0151en azonban a\n bal als\u00f3 v\u00e9gtagba sug\u00e1rz\u00f3 k\u00ednz\u00f3 f\u00e1jdalma megmaradt. A k\u00e9s\u0151bbi lumbalisgerinc-MR-\n \u00e9s a fizik\u00e1lis vizsg\u00e1lat alapj\u00e1n felmer\u00fclt a kor\u00e1bbi m\u0171t\u00e9ti ter\u00fclet k\u00f6rny\u00e9k\u00e9n\n hegesed\u00e9s, ez\u00e9rt lumbalis epidurolysist v\u00e9gezt\u00fcnk az 1 napos protokoll szerint.\n A beteg a beavatkoz\u00e1st k\u00f6vet\u0151en azonnal, illetve a 6 hetes kontrollon is\n jelent\u0151s f\u00e1jdalomcs\u00f6kken\u00e9sr\u0151l sz\u00e1molt be, f\u00e1jdalomcsillap\u00edt\u00f3t nem kellett\n szednie. Az epidurolysis indokolts\u00e1ga postlaminectomi\u00e1s szindr\u00f3m\u00e1ban I. szint\u0171,\n porckorongs\u00e9rvben \u00e9s canalis spinalis stenosisban radicularis f\u00e1jdalom egy\u00fcttes\n fenn\u00e1ll\u00e1s\u00e1val vagy a n\u00e9lk\u00fcl fell\u00e9p\u0151 gerincf\u00e1jdalmak kezel\u00e9sekor II. szint\u0171\n evidencia. Az epidurolysis avatott k\u00e9zben j\u00f3 hat\u00e1sfok\u00fa, biztons\u00e1gos \u00e9s\n k\u00f6lts\u00e9ghat\u00e9kony elj\u00e1r\u00e1s, k\u00fcl\u00f6n\u00f6sen akkor, ha t\u00e1rsadalmi hat\u00e1sait is figyelembe\n vessz\u00fck. Orv Hetil. 2025; 166(6): 234\u2013240.\n <\/jats:p>","DOI":"10.1556\/650.2025.33216","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T06:55:17Z","timestamp":1739170517000},"page":"234-240","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":0,"title":["Epidurolysis \u2013 egy r\u00e9gi-\u00faj elj\u00e1r\u00e1s"],"prefix":"10.1556","volume":"166","author":[{"given":"Anett","family":"Kiss","sequence":"first","affiliation":[{"name":"Budapesti Uzsoki Utcai K\u00f3rh\u00e1z, K\u00f6zponti Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Oszt\u00e1ly, F\u00e1jdalom Ambulancia Budapest, Uzsoki u. 29\u201341., 1145 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Udvarhelyi","sequence":"additional","affiliation":[{"name":"Budapesti Uzsoki Utcai K\u00f3rh\u00e1z, K\u00f6zponti Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Oszt\u00e1ly, F\u00e1jdalom Ambulancia Budapest, Uzsoki u. 29\u201341., 1145 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Istv\u00e1n","family":"Z\u00e1troch","sequence":"additional","affiliation":[{"name":"Budapesti Uzsoki Utcai K\u00f3rh\u00e1z, K\u00f6zponti Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Oszt\u00e1ly, F\u00e1jdalom Ambulancia Budapest, Uzsoki u. 29\u201341., 1145 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csaba","family":"Kopitk\u00f3","sequence":"additional","affiliation":[{"name":"Budapesti Uzsoki Utcai K\u00f3rh\u00e1z, K\u00f6zponti Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Oszt\u00e1ly, F\u00e1jdalom Ambulancia Budapest, Uzsoki u. 29\u201341., 1145 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Helm S, Racz GB, Gerdesmeyer L, et al. Percutaneous and endoscopic\n adhesiolysis in managing low back and lower extremity pain: a systematic review\n and meta-analysis. Pain Physician 2016; 19: E245.","DOI":"10.36076\/ppj\/2016.19.E245"},{"key":"R2","doi-asserted-by":"crossref","unstructured":"Manchikanti L, Knezevic NN, Navani A, et al. Epidural interventions\n in the management of chronic spinal pain: American Society of Interventional\n Pain Physicians (ASIPP) comprehensive evidence-based guidelines. Pain Physician\n 2021; 24(Suppl 1): S27.","DOI":"10.36076\/ppj.2021.24.S27-S208"},{"key":"R3","doi-asserted-by":"crossref","unstructured":"Chou R, Baisden J, Carragee EJ, et al. Surgery for low back pain: a\n review of the evidence for an American Pain Society Clinical Practice Guideline.\n Spine (Phila Pa 1976) 2009; 34: 1094\u20131109.","DOI":"10.1097\/BRS.0b013e3181a105fc"},{"key":"R4","doi-asserted-by":"crossref","unstructured":"Manchikanti L, Schultz DM, Atluri S, et al. Lumbar epidural\n injections. In: Manchikanti L, Kaye A, Falco F, et al. (eds.) Essentials of\n interventional techniques in managing chronic pain. Springer, Cham, 2018; pp.\n 141\u2013186.","DOI":"10.1007\/978-3-319-60361-2_11"},{"key":"R5","doi-asserted-by":"crossref","unstructured":"Urits I, Schwartz RH, Brinkman J, et al. An evidence based review of\n epidurolysis for the management of epidural adhesions. Psychopharmacol Bull.\n 2020; 50(4 Suppl 1): 74.","DOI":"10.64719\/pb.4383"},{"key":"R6","doi-asserted-by":"crossref","unstructured":"Bal\u00e1zsfi M, Szappanos N, Lehelv\u00e1ri G, et al. Our experience with\n minimally invasive decompression spine surgeries performed with microscopic and\n endoscopic visualization. [Mikroszk\u00f3pos \u00e9s endoszk\u00f3pos vizualiz\u00e1ci\u00f3val v\u00e9gzett,\n minim\u00e1lisan invaz\u00edv dekompresszi\u00f3s gerincm\u0171t\u00e9tekkel kapcsolatos\n tapasztalataink.] Orv Hetil. 2023; 164: 1926\u20131937. [Hungarian]","DOI":"10.1556\/650.2023.32926"},{"key":"R7","doi-asserted-by":"crossref","unstructured":"Racz GB, Holubec JT. Lysis of adhesions in the epidural space. In:\n Racz GB. (ed.) Techniques of neurolysis. Springer, Boston, MA, 1989; pp.\n 57\u201372.","DOI":"10.1007\/978-1-4899-6721-3_6"},{"key":"R8","doi-asserted-by":"crossref","unstructured":"Manchikanti L, Rivera JJ, Pampati V, et al. One day lumbar epidural\n adhesiolysis and hypertonic saline neurolysis in treatment of chronic low back\n pain: a randomized, double-blind trial. Pain Physician 2004; 7:\n 177\u2013186.","DOI":"10.36076\/ppj.2004\/7\/177"},{"key":"R9","doi-asserted-by":"crossref","unstructured":"Racz GB, Heavner JE, Raj PP. Epidural neuroplasty. Semin Anesth\n Perioper Med Pain 1997; 16: 302\u2013312.","DOI":"10.1016\/S0277-0326(97)80014-1"},{"key":"R10","doi-asserted-by":"crossref","unstructured":"Manchikanti L, Singh V, Cash KA, et al. Assessment of effectiveness\n of percutaneous adhesiolysis and caudal epidural injections in managing post\n lumbar surgery syndrome: 2-year follow-up of a randomized, controlled trial. J\n Pain Res. 2012; 5: 597\u2013608.","DOI":"10.2147\/JPR.S38999"},{"key":"R11","doi-asserted-by":"crossref","unstructured":"Manchikanti L, Soin A, Boswell MV, et al. Effectiveness of\n percutaneous adhesiolysis in post lumbar surgery syndrome: a systematic analysis\n of findings of systematic reviews. Pain Physician 2019; 22:\n 307\u2013322.","DOI":"10.36076\/ppj\/2019.22.307"},{"key":"R12","doi-asserted-by":"crossref","unstructured":"Gerdesmeyer L, Wagenpfeil S, Birkenmaier C, et al. Percutaneous\n epidural lysis of adhesions in chronic lumbar radicular pain: a randomized,\n double-blind, placebo-controlled trial. Pain Physician 2013; 16:\n 185\u2013196.","DOI":"10.36076\/ppj.2013\/16\/185"},{"key":"R13","doi-asserted-by":"crossref","unstructured":"Gerdesmeyer L, Noe C, Prehn-Kristensen A, et al. Long-term efficacy\n of percutaneous epidural neurolysis of adhesions in chronic lumbar radicular\n pain: 10 year follow-up of a randomized controlled trial. Pain Physician 2021;\n 24: 359\u2013367.","DOI":"10.36076\/ppj.2021.24.359"},{"key":"R14","doi-asserted-by":"crossref","unstructured":"Manchikanti L, Knezevic NN, Knezevic E, et al. Efficacy of\n percutaneous adhesiolysis in managing low back and lower extremity pain: a\n systematic review and meta-analysis of randomized controlled trials. Pain Ther.\n 2023; 12: 903\u2013937.","DOI":"10.1007\/s40122-023-00508-y"},{"key":"R15","doi-asserted-by":"crossref","unstructured":"Han YJ, Lee MN, Cho MJ, et al. Contrast runoff correlates with the\n clinical outcome of cervical epidural neuroplasty using a Racz catheter. Pain\n Physician 2016; 19: E1035\u2013E1040.","DOI":"10.36076\/ppj\/2016.19.E1035"},{"key":"R16","doi-asserted-by":"crossref","unstructured":"Racz GB, Racz GJ, Tariq M. Complications of caudal epidural lysis of\n adhesions. In: Erdine S, Staats PS (eds.) Complications of pain-relieving\n procedures. John Wiley & Sons, New York, NY, 2022; pp.\n 329\u2013338.","DOI":"10.1002\/9781119757306.ch39"},{"key":"R17","doi-asserted-by":"crossref","unstructured":"Kupovits TR. Treatment options for low back pain: the importance of\n patient education. [A der\u00e9kf\u00e1jdalom kezel\u00e9si lehet\u0151s\u00e9gei: a betegoktat\u00e1s\n jelent\u0151s\u00e9ge.] Orv Hetil. 2024; 165: 1562\u20131569. [Hungarian]","DOI":"10.1556\/650.2024.33135"}],"container-title":["Orvosi Hetilap"],"original-title":[],"link":[{"URL":"https:\/\/www.akjournals.com\/view\/journals\/650\/166\/6\/article-p234.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.akjournals.com\/downloadpdf\/journals\/650\/166\/6\/article-p234.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.akjournals.com\/downloadpdf\/journals\/650\/166\/6\/article-p234.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:17:55Z","timestamp":1785496675000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.akjournals.com\/view\/journals\/650\/166\/6\/article-p234.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,9]]},"references-count":17,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.1556\/650.2025.33216","relation":{},"ISSN":["0030-6002","1788-6120"],"issn-type":[{"value":"0030-6002","type":"print"},{"value":"1788-6120","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,9]]}}}