RACZ caudal neurolysis is carried out to eliminate pain in the lower part of the back as well as pain radiating down the legs, which are most frequently caused by scarring after prior surgeries. Medications used in RACZ caudal neurolysis reduce swelling and scar tissue, which cause nerve pinching. During RACZ caudal neurolysis the patient lies face down with a cushion placed under the stomach area to arch the back and for comfort.

The physician uses fluoroscope to find small opening at the base of sacrum called sacral hiatus. A local anesthetic is used to numb the skin down to sacral hiatus surface. The physician place a needle into the epidural space and injected contrast solution to see scarred and painful areas using fluoroscope. Then small catheter is placed through the needle close to scarred tissue.

A mixture of anesthetic and steroid medication is injected to dissolve the scar tissue and needle and catheter are removed. Sometimes it is necessary to keep catheter on the place for more injections over next several days or to repeat the procedure a few months later to reduce scar tissue further.


Common side effects could be compared with common injection side effects, i.e. allergic reaction, bacterial infection, bleeding in seldom cases. Steroids side effects are face, eyes, arms, legs swelling, sugar level increasing for diabetic patients.

The patient must inform the physician about pregnancy or if he/she takes blood thinning medication.

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