Spine: Spinal Catheter Technique
Minimal Invasive Epidural Catheter Technique - the Racz Method
The spinal catheter can be guided exactly into place through the use of image intensifying
technology and epidurography (contrast medium x-ray of the epidural space of the spine).
The procedure sets itself apart from other catheter pain management procedures through its
unique technology - a flexible catheter specially outfitted with a small probe. This technology
makes precise treatment of affected nerve roots possible.
A special cannula is inserted into the epidural space of the spine under local anesthesia:
in the coccyx (tailbone) for thoracic and lumbar procedures, and in the upper part of the
thoracic spine for cervical (neck) procedures. The specially developed probe is brought
exactly into place near the spine through use of image intensifying technology and contrast medium.
The procedure works by reducing swelling and fluid build-up in affected tissues, thereby relieving
the irritated nerve root. This is often combined with mechanical freeing of the nerve root from
structures that may be adhering to it. By precise injection of various medications
(pain and anti-inflammation medications, saline solution) an osmotic effect can be achieved
which reduces tissues swelling and with it nerve root irritation. Inflammation disappears.
Pain is treated at the source. An additional special enzyme solution is injected to loosen
and dissolve scarring and adhesions near the spinal cord.
The entire procedure takes only 30-40 minutes. In as little as an hour after the procedure
the patient can stand up and move around. An in-patient stay usually lasts three to four days.
During this time the patient receives four further injections of pain medication, saline solution
and enzymes through the catheter.
- severe acute pain of protruding or herniated disks
- severe chronic pain and irritation of nerve roots
- post-nucleotomy syndrome (pain following herniated disk surgery)
- post-operative epidural scarring and fibrosis
- nerve root irritation/nerve root irritation syndrome through mechanical stresses
- hypertrophied ligamentum flavum or hypertrophied facet joint arthrosis
The epidural catheter technique makes major surgical procedures unnecessary for a majority of
patients with protruding or herniated disks. Patients with chronic back pain following back surgery
or those with scarring following surgery for facet joint arthrosis can expect dramatic improvement,
even complete recovery of function. With the two-catheter technique a second catheter can be
separately inserted in order to overcome scar tissue or anatomic anomalies, allowing an injection
to reach the exact site of irritation.
The procedure is performed under local anesthesia. The catheter employs a stainless steel spring tip for
gentle, injury-free placement. Compared with normal surgical procedures the catheter technique reduces disk
swelling without causing injury.
The in-patient stay lasts three to four days. Light physical activity such as office work can be resumed after
A coordinated program of physical therapy should already begin two weeks after treatment. Isometric strength
to gradually resume normal sport and fitness activity.
Light physical work such as office work can be resumed after one to two weeks. Heavy physical work should be
avoided during the first four weeks and can gradually be resumed thereafter.
Swimming and bike riding (both emphasizing upright posture are allowed after three weeks. Jogging on soft
surfaces is possible after four weeks. All other sports can be gradually resumed after the fifth week
depending on their degree of intensity.
A success rate of over 85% is reported in the international literature.