%0 Journal Article %T Lisis de adherencias epidurales (Parte 2): T谷cnica intervencionista Percutaneous epidutal lysis of adhesions (2): Interventional technique %A G. Racz %A J. C. Flores %J Revista de la Sociedad Espaˋola del Dolor %D 2013 %I Sociedad Espa?ola del Dolor %X This technique consists in the use of catheters and special needles to introduce solutions into difficult access sites in order to treat fibrosis or chronic inflammation conditions. Solutions such as hyaluronidase and hypertonic saline solution can be used for the lysis of adhesions caused by the pathology. This paper refers to different alternatives to correctly apply the technique at different spine levels. The technique has evolved from the conventional Tuhoy solution needles with some neurolitic properties to modern mapping needles and catheters that permit to position the desired solution at a distance, close to the desired root and/or foramen. The most frequently affected area is the sacrolumbar segment, but different nosological entities that require clinical or surgical treatments may cause pain in the spinal canal, discs, vegetative structures or roots in any spinal segment. Many of these pathologies, most particularly after surgical treatments, cause inflammatory conditions and epidural adhesions that frequently lead to chronic pain. The pathophysiology and indication of this technique is developed in Part 1 of this publication. This paper describes the techniques to perform lysis of adhesions at all spine levels. A thorough description is made of the caudal, lumbar, thoracic and cervical technique, the solutions administered, the catheters that are used in each case and physical therapy techniques for neural and epidural mapping. All techniques described are illustrated by an "Image gallery" for each procedure. The appropriate use of images is indicated with volume differences in each case. Tips for preventing complications are given. La t谷cnica lisis de adherencias epidurales se basa en la introducci車n de cat谷teres a trav谷s de agujas especiales con una t谷cnica determinada para permitir colocar soluciones en lugares de dif赤cil acceso, con el objeto de resolver cuadros cr車nicos de fibrosis o inflamaci車n. Las soluciones como hialuronidasa y soluci車n fisiol車gica hipert車nica principalmente permiten provocar la lisis de las adherencias resultantes de la patolog赤a. Se desarrollan en esta publicaci車n las distintas alternativas para aplicar correctamente la t谷cnica en los distintos niveles de la columna vertebral. La t谷cnica ha evolucionado desde la inyecci車n a trav谷s de agujas de Tuhoy convencionales de soluciones con alguna propiedad neurol赤tica hasta las modernas agujas y cat谷teres con mapeo que permiten posicionar a distancia la soluci車n deseada cerca de la ra赤z y/o el foramen indicados. Las dolencias y consultas m谷dicas afectan m芍s frecuentemente %U http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1134-80462013000100005