Objective: Postoperative epidural fibrosis, being a part of failed back surgery syndrome (FBSS), is a frequent sequelae of lumbar disc surgery which is difficult to treat. The second surgery does not yield good results.No single treatment modality of epidural fibrosis achieves good results. This is the reason for trying of new approaches to its treatment. Design: Retrospective, observational questionnaire based study. Setting: Department of Neurosurgery, Central Military Hospital, Praha. Material and methods: We studied a cohort of the first epidural administration of hyaluronidase to 100 patients with history of one or more lumbar disc surgeries and residual pain typical for epidural fibrosis. Results: In the follow-up period of more than 12 months after administration of hyaluronidase, VAS improved by 1 to 3 points in 16% of patients, 3 to 5 points in 30 % of patients and more than 6 points in 21 % of patients. In 25 % of patients the pain intensity did not improve, in 10% even deteriorated. Conclusion: The efficacy of hyaluronidase treatment itself is a proof of clinical importance of epidural fibrosis. Epidural administration of hyaluronidase is one of the least invasive treatment modalities of epidural fibrosis. The potential for its positive effect in the treatment of FBSS should not be neglected even though it could not be seen in all cases.

        Key words: epidural fibrosis – failed back surgery syndrome (FBSS) – hyaluronidase – epidural administration