Four RCTs, two prospective studies and two retrospective studies were included in the review (n=553, range 25 to 129 patients). All four RCTs reported adequate randomisation, but only two were adequately blinded. Three RCTs had comparable baseline patient characteristics. Follow-up data was collected at one, three, six and 12 months.
All four RCTs reported improvements in pain relief with adhesiolysis in both short and long terms, as compared with controls (patients as their own controls or compared with other patients). Both prospective studies showed improvements in the short and long term. Both retrospective studies reported improvements in the short term, but showed mixed results in the long term.
All eight studies showed improvement in pain relief with adhesiolysis compared with either epidural steroid injections or after failed treatment with epidural steroid injections.
Six studies reported some evidence of subarachnoid block or puncture, infection or abscess, catheter complications and other minor complications such as rash and itching. Findings were reported in the review. Other outcomes were reported in the review.