Scar Tissue – What is Epidural Scar Tissue?

Scar tissue, also known as cicatrices, can affect many different areas within the body.   This article concentrates on scar tissue affecting the spinal area, generally after back surgery.   The body cannot re-create healthy tissue.  Scar tissue is the way the body repairs itself when there is damaged tissues.   It is an epidural fibrosis connective tissue located near the nerve root that is created to replace internal damaged tissue.

The formation of scar tissue is the beginning of an internal healing process that occurs after an injury, cut, surgery, or disease has disrupted the tissue.   The scar tissue will help to bring the separated ends of the interrupted tissue together.     It will act as a protective barrier, although it is not as healthy as the previous tissue.  Nearly every wound will result in some type of scarring.  It all depends on the severity of the wound or interruption as to how much scar tissue will develop.

Scar Tissue Differences from Original Tissue

Scar tissue is not identical to the original tissue.   It is made of lesser quality and is not as functional.   For example, scar tissue is less resistant to ultraviolet radiation.   It is also limited when it comes to movement, circulation, and sensation.

Is Scar Tissue the Cause of Pain?

This is a controversial topic; however, it is believed that the actual scar tissue itself is not the cause of back pain.  Rather, it is the binding of scar tissue to the lumbar nerve that causes the pain.  While the scar tissue itself is not painful, the binding causes the pain.  Therefore, scar tissue is considered to be the cause.

Differences between Internal Scar Tissue and External Scar Tissue

After back surgery, the body’s natural healing abilities create internal scar tissue in the areas where the muscles and tissues have been cut or torn.   These scars are considered to be “internal”.  Internal scar tissue is different than external scar tissue in a couple of different ways.

Internal scar tissue often creates tethers, barriers, and adhesions that will form on the nerve areas, which can cause pain when they are pulled out of place.  Tethers are formed when the scar tissue goes beyond the area that was cut during the surgery.  A biological barrier can also be formed, which is scar tissue that forms a wall that does not heal properly.  Both tethers and biological barriers can cause pain when they pull internal tissues out of their original place.

Treatment

The pain caused by scar tissue may go away on its own.  It is likely that a doctor will prescribe medication to help with the pain.  However, if the pain continues after back surgery it is possible that a doctor will decide to perform a diagnostic laparoscopy to accurately diagnose the pain as being caused from scar tissue.   If pain medication is not working, laparoscopic adhesiolysis may be an option.  While this is a long surgery, it is preferred to open surgery as to help prevent more scar tissue from forming.  This surgery is less invasive and will allow a patient to have the surgery on an outpatient basis and return to normal activities within a week’s time.

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