interlaminar approach for epiduroscopy in patients with failed back surgery syndrome background epiduroscopy is a relatively new diagnostic and therapeutic technique used in patients with chronic low back pain with or without radiculopathy we present our experience with a new interlaminar approach in patients with failed back surgery syndrome fbssmethods patients with severe symptoms of fbss who did not respond to other treatments were included lumbar epiduroscopy was performed via interlaminar approach through a 14 g epidural needle under fluoroscopy a flexible 077 mm endoscope was introduced through a 4f catheter into the epidural space and advanced in a cephalad direction flushes of normal saline through the catheter via a yadapterhaemostasis valve enabled distension of the space adhesions were mechanically mobilized under direct vision a mixture of triamcinolone 60 mg hyaluronidase 600 iu and bupivacaine 00625 was instilledresults nineteen patients were included the mean number of operations at lumbar level was 226 major findings included adhesions inflammation stenosis and nerve root hypotrophia the visual analogue scale vas score was 789 at baseline 595 p0001 3 months later and 605 p0001 6 months later six patients 316 did not show any improvement and six other patients showed a very significant improvement at least three points reduction in the vas 3 months later we had four cases of dural puncture but only one patient required hospital admissionconclusions we have described a new procedure for epiduroscopy with approximately 50 reduced outer diameter of the catheter which allows interlaminar approach its diagnostic efficacy is clear and there were a significant number of patients who had improved outcome