Epiduroscopy and radiofrequency technique: the Raffaeli–Righetti technique

Abstract Objectives: Periduroscopy has been re-evaluated only recently for the diagnosis, and especially the treatment, of complex rachidian pain, such as that due to the failed back surgery syndrome (FBSS). The classic periduroscopy procedure has major limitations in that it can only use liquids as a method to visualize the dura space, and cannot overcome fibrotic (partial or complete) obstructions of the channel. In order to overcome these limitations, we added two modifications to the classic procedure – the Raffaeli–Righetti technique. Patients and methods: A Fogarty balloon was used to clean the channel. This tool has allowed reduction by 50% of the volume of fluid used in the periduroscopy. The second innovation involves the use of the resaflex for the lysis of channel obstructions (fat and/or fibrotic tissues), which allows reaching the site of pain origin and improving the efficiency of the periduroscopy by 30%. The resaflex uses an electric wave to lyse tender tissues (lysing and coagulating at t...