Analgesic Efficacy of Epidural Neuroplasty via Racz Catheter During Lumbar Fixation In Situ for Lumbosacral Spondylolisthesis: A Randomized Controlled Trial.

BACKGROUND

Effective pain management after lumbar fixation in situ is crucial for improving recovery and quality of life. Epidural neuroplasty via the Racz catheter is a potential method to enhance analgesia by targeting epidural inflammation and nerve compression. This work assessed the analgesic efficacy of epidural neuroplasty via a Racz catheter during lumbar fixation in situ for lumbosacral spondylolisthesis.

METHODS

This randomized, double-blinded, controlled study was conducted on 50 patients aged 18-65 years, of both sexes, who had Grade 1 spondylolisthesis, facet osteoarthropathy, and a small disc on radiological findings. Participants were randomly assigned to two equal groups. Group S received epidural neuroplasty via a Racz catheter during lumbar fixation, and Group C received conventional lumbar steroid injections.

RESULTS

Visual analog scale and Oswestry low back disability questionnaire scores were significantly diminished immediately postprocedure and at 1, 2, 4, and 6 m in Group S than in Group C (p < 0.05). Hypotension, paraesthesia, bleeding, and headache exhibited comparability between the two groups. The patient satisfaction level was significantly elevated in the Racz catheter group as opposed to the conventional lumbar group (p < 0.05).

CONCLUSIONS

Epidural neuroplasty using a Racz catheter during lumbar fixation provides enhanced short-term analgesia, functional recovery, and patient satisfaction compared with conventional lumbar treatment in Grade-1 spondylolisthesis, without increased adverse effects, providing preliminary evidence that warrants validation in larger, long-term studies. Trial Registration: ClinicalTrials.gov identifier: NCT06684821.