Anyone tried hydrosection/neurolysis to remove scar tissue?
 

Hi!

How are you? My doctors think that I have scar tissue in my sciatic nerve which might be causing my RSD, or at least irritating my nerve too much. I had an injury to my leg a long time ago and it never healed fully. PRP worked a bit but I still get so much worse when I move my leg. That's why my doctors and I think I might have scar tissue there and that the sciatic nerve is not gliding smoothly within the nerve sheath.

My doctor suggested I get hydrosection, which I think other doctors call neurolysis. In the procedure the doctor inserts a watery substance (I don't know what exactly) next to the nerve to somehow make more space for the nerve and to separate it from the scar tisssue.

I really want to do this, but I wonder if this could do more damage than good. My nerve is extremely sensitive, I can hardly stretch my leg or even flex my foot for too long. Anything that stretches my nerve is potentially very panful and damaging. So it makes a lot of sense that I have scar tissue. But at the same time I wonder if the increased pressure resulting from the "water" could further make it all more painful.

Does anyone have info on this type of procedure? Have you had it done? Did it help you? Any info is greatly appreciated!

Thanks for reading my post. I hope you are doing very well and having a good day today!

I know they are doing this on Carpal Tunnel patients. Have you had an MRI that shows if there is scar tissue entrapping the sciatic nerve? I have scar tissue around a couple of nerves in my pelvis and the hope is if we can get the nerves freed up maybe the RSD in my legs will settle down. Imaging scar tissue around nerves is tricky. I went to NYC for a special MRI by Dr. Potter at Hospital for Special Surgery as she has worked on a technique to image scar tissue around the nerves in the pelvis. I had several MRI's before the one she did, all normal but her MRI showed the scar tissue and matched my areas of symptoms perfectly. Now I have a much better feel for what surgeries I need to release the nerves. I don't know where you live but an MRI with her would show if you have scar tissue around the sciatic nerve plus if you had scar tissue around say the posterior femoral cutaneous nerve also. It might help sort things out.

I just want to say good luck and I said a prayer for both of you guys. May the doctors hands and brains be guided. Hang in there, this sounds so scary to me anything dealing with nerves just sounds like big RSD flare up. This is interesting and I have never heard about it. I pray that if you go forward with it you get massive relief and you get your life back :) Stay strong!!!


Hannah

Hi NYT2!

Thanks! I was so excited to read about the special MRI. It has been so absolutely frustrating that my multiple MRI's don't show a thing, despite my symptoms! I was wondering if Dr. Aaron Filler's neurography would show scar tissue of my sciatic nerve, hamstring area, but Dr. Potter might just be the answer with her special MRI. I will try to see her. What is her first name? With her full name I can look for her phone online. What is her specilaty? Does that MRI test have a specific name or should I just tell her that I am looking to find where the scar tissue might be and she will know what to order? I really can't tell you how hopeful and happy your information has made me. I thank you so much. My docs and I have suspected there is scar tissue somewhere in my leg or pelvis for seven years now but knowing where has been sadly impossible.

Sorry to hear though, that you have RSD. I hope this is the answer for you. I hope we can continue to be in touch both of us because if I do have the hydrosection that could be useful information for you too, as it is a much less invasive procedure than surgery. And I really would love to see how are doing later on.

Hannah1234:

Thanks so much for the good wishes! I really appreciate it. I also hope that you get 10000% better very soon. You stay strong too as we, all together, will beat this thing.

Hi Hannah,

I wrote a long post and then lost it. I'm using my daughters laptop, mine is down until I install a new hard drive, and her keyboard is so weird to me.

My scar tissue problem was upper extremity. I had 2 contracture releases done the 1st was not successful the second done at HSS was a complete success. I am not aware of the procedure you are talking about but my surgery which also including a ulnar nerve transposition was about 7 hours and the use of a CPM Machine almost immediately after surgery, fun, fun, fun. But I did have success and it was done with the RSD on board. But time was not on my side I had to do it to get the arm back.

The Hospital For Special Surgery is a wonderful place. Filled with just the best doctors, equipment, nurses etc. the food not so good. But there's a great deli just on the corner, my husband was a regular there.

I had a very odd injury. I have been told the chances of what happened to my arm when I fell, I was rollarblading, was 1 in 500,000. When a doctor makes a statement like that and he was not the first one I think I saw 6 surgeons before I got to HSS of course you start to ask many questions. The one thing I was told many times by not just my surgeon but my PM doctor, the many fellows that worked with me, the PT people is that nerve surgery is a very serious business and the surgeon must have extensive experience.. I was very happy with my whole journey through HSS. I have spend probably 30 days in that hospital if I ad up all the surgeries, ketamine procedures etc,.

I wish you the best.

Gabbycakes

I don't know about Dr. Potter, but I have heard that Dr. Filler's neurography will almost always show scar tissue, at least to him, if not to someone else looking at the same images. Then too, there was always the issue of whether a surgical procedure to resolve an entrapment would just create it's own scar tissue. That said, there were RSD patients in town who swore by him a few years ago - roughly 8-10 years back - but I frankly haven't heard his name raised in the local CRPS community in a long time.

While the water massage technique sounds intriguing, I could easily imagine that it might be difficult to balance the amount of force necessary to dislodge to old scar tissue with that which could sever the nerve entirely. In any event, I wouldn't be comfortable doing it without first seeing published human studies in a peer reviewed journal, and involving the sciatic nerve at that.

Of course, imposing a published peer reviewed study requirement could inject conservative bias, where new ideas are sometimes difficult to publish in established [read: Establishment] medical journals. On the other hand, with the proliferation of peer reviewed online journals, it's probably easier for a good study to find its way to publication than it once was.

For what it's worth.

Mike

Hollis G. Potter, MD Chief, Magnetic Resonance Imaging Hospital for Special Surgery Professor of Radiology Weill Medical College of Cornell University

The address is as follows.
Hospital for Special Surgery
Magnetic Resonance Imaging
535 East 70th Street, New York NY 10021
Basement level Left

Appointment Desk
Tel 212-774-7296
Fax 212-774-7295

To be reviewed by Dr. Hollis Potter:

Please have it faxed to 212-774-7295 by your doctor.
and then call MRI department at 212-774-7296 to schedule an appointment.

I had an email but can't find it. If I do find it I'll post.

Regarding Dr. Filler's MRN there has been alot on the pudendal hope forum trying to figure out which is better his MRN or Dr. Potter's MRI. So far there have been several confirmations of of what she has seen on the MRI by surgical decompression of the pudendal nerve. The best part she looks at all the other nerves in the pelvis, muscles, tendons, etc. Insurance companies will pay for her MRI but they usually do not pay for the MRN. There have been a fair number of individuals on the pudendal forum who have had the MRI with her and leave with information that matches their symptoms.

When you call make sure they know you need the sciatic nerve looked at specifically with any specific areas of the sciatic nerve, hamstring, maybe even the posterior femoral cutaneous nerve as there is some overlap with innervation.

Good luck.

I apologize I didn't put 2 and 2 together. Yes, Dr. Hollis Potter did do all my MRI reviews and from my experience she was wonderful. I had to have quite a few because I have titanium in my arm and MRI's are not very clear when titanium exist so sometimes they had to be repeated. But the "special MRI" machine is suppose to be the best and only available at HSS. I believe Dr. Schwartzman even sends patients up to NYC for this special MRI.

Gabbycakes

Gabbycakes:

Thanks for letting me know about your experience with Dr. Potter and for telling me about how good that whole hospital is. It really sounds like it is a great place with great doctors!

Sorry to hear about your surgeries but I am glad you had such a great team of specialsits on board. One chance in 500,000 and you got this. I would think that my chances of getting so sick were in that ball park too.


Not too long I posted in the old thread what the doctor told me about how to find doctors who do the Vitamin c. intravenous vitaminc c and magnesium have work great for me.

NYT2:
I wrote you a long PM. Thanks for the info! :)

Michael:
I don't have any hopes of a peer reviewed study coming out soon. Thanks for your comments though. I hope I will be lucky if I have it done. I sure wish someone with rsd who has had it done could tell me how safe it is...

I don't have RSD in that part of my body (thigh) and PRP helped me a lot before. As long as hydrodissection does not causes rsd I should be fine.

Thank you all for your help! Hope you are havinga good day!

And you're almost certainly correct, in terms of full-on randomized double-blind studies. But wouldn't at least a couple of published case reports be reassuring?

Thanks, Janejane,

I have heard of the vitamin c a friend of mine swears by them and she has RSD and has been through hell. She is much better after much suffering and she swears by those vitamin shots. Thanks for the info.

It was quite a blow. Normal 1 second and the next a mess. Someday's I think if I did not find those doctor where would I be? When I finally made the commitment to HSS, my arm was a mess, I would of lost functioning completely if I didn't do what I did there. And honestly I was afraid. All the talk of all the surgeries with the RSD on board then came the ketamine not once but 3x's, traveling to Philly for boosters, that Dr. getting involved. Then came the legal fight which I don't know which was worse the surgeries or the trial, which I won. In NJ the law is very clear on slip and falls, thank god my husband went back the next morning and took pictures, they never even cleaned the blood up or the area where I fell. So that went on for 2 years, then came the disability fight, again took 2 years but I got it finally.

I had a wonderful career as a software consultant at one point working as a IBM/VAR which just was a wonderful experience and I loved it and miss it so much. Today I call myself a "Independent Business Consultant" it a fancy work for a traveling bookkeeper. But Social Security told me when I filed I could at least work PT, so I immediately went out and started this. They allow you to make a certain dollar amount before they deduct from your check so I just watch the dollars I make. Social Security does not care if you work 80 hours a week just don't go over that dollar amount. I find that so strange, but it is what it is.

But if anything good came out of it was a more appreciation of life, not just for me but for my husband and children. We lived the "american dream" and then had to adjust everything and it taught us all a very important lesson and today I think we a better people and a stronger family.

Thanks again,

gabbycakes

Hi Gabby Cakes!

Thanks for your reply! It makes me so happy to hear that you are doing so much better with the help from HSS. Life with RSD can be unbearable enough, but not having a good team of doctors and caring practitioners can make it so much worse. It really sounds like you have been through so much. It was definitely so very smart to take those pictures after you fell. Pictures make all the difference in the world!! I am glad they were careless enough not to clean up because that helped you later on.

It's great that you can still work but never doubt too much that you will be able to go back to your old job. This thing RSD can be beaten. I really believe it. I just think of all those patients who had RSD a hundred, a thousand years ago, and had nothing to help them. AT least now, the condition is recognized.

Please let me know who you think are the best doctors at HSS. If you want you can PM me with the names. I am always looking for good doctors because my docs are really nice, but they dont have enough expereince with RSD and so I find myself looking for true specialists who know what they are doing.

I send you a big, warm, gentle hug!!!:)

Have a great weekend!