1. Chronic refractory low back and lower extremity pain secondary to post lumbar surgery syndrome, spinal stenosis, and disc herniation is common.

2. Disc herniation, spinal stenosis, and postsurgery syndrome is managed with multiple interventional techniques, implantable therapies, or repeat surgical interventions.

3. The present systematic review identified seven high-quality and two moderate-quality randomized controlled trials (RCTs) evaluating the role of percutaneous adhesiolysis in managing chronic recalcitrant low back and lower extremity pain.

4. The evidence is level I to II with moderate to strong recommendation in managing low back and lower extremity pain after failure of conservative management and fluoroscopically directed epidural injections.

5. Significant paucity of the literature and heterogeneity among available trials continues to be an issue, resulting in an ongoing debate regarding efficacy, effectiveness, indications, and medical necessity.